Domefiic  Medicine:
               OR, A
          TREATISE
               ON THE
       PREVENTION AND CURE

         DISEASES,  '
 BY REGIME AND SIMPLE MEDICINES:
               WITH
          AN APPENDIX,
CONTAINING A DISPENSATORY FOR THE USE OF
        PRIVATE PRACTITIONERS.

     BY WILLIAM BUCHAN, M. D.
  Fellow of the Royal College of Physicians, Edinburgh,
Adapted to the Climate and Difeafes of America, by
        ISAAC CATHRALL.
       PHILADELPHIA:
PRINTED BT RICHARD FOLWELL.
            1799. 
fl          COPY-RIGHT
&   SECURED ACCORDING TO LAW.
 
PREFACE.
JTXMONG the motives which have induced me to r«-
publifh Dr. Buchan's book on Domestic  Medicine,
is  that of rendering it more extenfively ufeful  to  the
inhabitants of the United States of America, by accom-
modating  it to  their  difeafes.  Although it contains a
comprehenfive defcription of the  difeafes  incident  to
the nations of  Europe, and is  too well known  by  its
celebrity  to the world, to require any encomium from
me, yet the variety to  which difeafes are fubjeft frora
climate, makes it  fomewhat deficient when applied to
thofe of America :  To fupply  that defect is the object
of this publication.  How  far I have, fucceeded  in the
accomplimment of  my defign, muft  be decided by the
candour of the public,  to whofe judgment it is now with
diffidence  fubmitted, without any farther apology than
a concioufnefs  of meaning well, and  a defire of  folici-
ting that portion of indulgence, which is due to  every
attempt to promote the good of mankind.

                           ISAAC CATHRALL.
Philadelphia, Auguft 20,  1797. 
CONTENTS
      PART  I.
  Of the general Caufes of
        Difeafes.
     CHAPTER I.
    OF Children  Page 23
    —Pifeafed Parents 26
*—Clothing of Children 28
•—Food of do,        32
-—Exercife of do.      36
—Effects of unwholefome
  Ajr upon do.       41
—Nurfes            43
     CHAPTER II.
Of the Laborious, &c.  45
<—-the Sedentary        51
r—the Studious        55
     CHAPTER III.
Of Aliment          60
     CHAPTER IV.
Of Air               67
     CHAPTER V.
Of  Exercife          71
     CHAPTER VI.
Of Sleep             75
•^--Clothing           j 6
     CHAPTER VII.
Of Intemperance      79
    CHAPTER VIII.
Of Cleanlinefs        82
     CHAPTER IX.
Of fcifeftioa          86
CHAPTER X.	
Of the Paffions	. ?9
—Anger	ibid.
—Fear	90
—Grief	92
—Love	94
■—Religious Melancholy 95	
CHAPTER XL	
Of common Evacuations 95	
—Stool	ibid.
—Urine	97
—Perfpiration	98
Are affeded by (Ganges	
in the Atmofphere	ibid.
—Wet Clothes	99
—Wet Feet	ibid.
—Night Air	100
—Damp Beds	ibid,
—Damp Houfes	101
—Sudden Tranfitionj	
from Heat to Cold	102
     PART  IL
       Of Difeafes.
    CHAPTER XII.
Of the Knowledge and
  Cure of Difeafes   105
    CHAPTER XIII.
Of Fevers in General 108
    CHAPTER XIV.
Of Intermitting Fevers
  or Agues         J13 
CONTENTS.             5
    CHAPTER XV.
Of  an acute continual
  Fever            118
    CHAPTER XVI.
Of the Pleurify       122
—Baftard do.        125
—Paraphrenias      126
    CHAPTER  XVII.
Of  a Peripneumony, or
  Inflammation  of  the
  Lungs            126
    CHAPTER  XVIII.
Of  Consumptions    128
    CHAPTER  XIX.
Of  the Slow or Nervous
  Fever             137
    CHAPTER XX.
Of the Malignant, Putrid,
  or SpqjE&d Fever    141
    CHAPTER XXI.
Of the Miliary Fever  147
    CHAPTER XXII.
Of the Remitting Fever 150
    CHAPTER  XXIII.
Of  the Yellow Fever 152
   CHAPTER  XXIV.
Of the Small Pox     167
—Inoculation        174
    CHAPTER XXV.
Of the Chicken-Pox  182
    CHAPTER  XXVI.
OftheMeafles       183
  Scarlet Fever ,     186
  Bilious Fever .     187
  CHAPTER XXVII.
Of the Eryfipelas, or St.
   Anthony's Fire     188
   CHAPTER XXVIII.
Of the Phrenitis, or In-
  inflamatioil of the
  Brain             192
  CHAPTER  XXIX.
Of the Opthalmia, or In-
 flammation of the Eyes 194
   CHAPTER XXX. '
Of the Quinfey, or In-
  flammation  of the
  Throat           198
—Malignant do.     202
—Cynanche Parotidsea,
  or Mumps        205
   CHAPTER  XXXI.
Of Colds and Coughs 205
—Common Cough   208
—Hooping-Cough   210
   CHAPTER XXXII.
Inflammation of the Sto-
  mach & otherVifcera 213
—Of the Interlines    215
OftheCholic        217
Inflammation of the Kid-
  nies               221
—Of the Bladder     223
—Of the Liver       224
   CHAPTER  XXXIII.
Of the Cholera Morbus,
   andotherexcefilveDif-
   charges from the Sto-
   mach and Bowels   226
—a Diarrhoea, or Loofe-
   nefs              228
—Vomiting          230
   CHAPTER XXXIV.
 Of the Diabetes, and other
   Diforders of the Kid-
   nies and Bladder   232
 —Suppreflion of Urine 234
—the Gravel & Stone 236 
«
CONTENTS.
   CHAPTER XXXV.
 Of Involuntary Difchar-
   ges of Blood       238
 —Bleeding at the Nofe 240
 —The Bleeding & Blind
   Piles              242
 Spitting of Blood      244
 Vomiting of do.      246
 Bloody Urine        247
 Dyfentery, or Bloody-
   Flux              248
 Coeliac Paffion       253
   CHAPTER XXXVI. *
 Of the Head-Ach     253
 —Tooth-Ach         256
 —Ear-Ach           258
 Pain of the ftomach, &c. 259
  CHAPTER XXXVII.
 Of Worms           261
 CHAPTER  XXXVIII.
 Of the Jaundice       264
 ' CHAPTER XXXIX.
 Of the Dropfv      266
    CHAPTER  XL.
 Of the Gout         270
—Rheumatifm      275
    CHAPTER XLI.
 Of the Scurvy       278
—Schrophula, or King's
   Evil             281
—Itch               283
   CHAPTER XL1I.
The Afthma         286
   CHAPTER XLIII.
Of the Apoplexy     288
   CHAPTER XLIV.
Of Coftivenefs, and other
  Affections of the S to-
  rn-.:ch and Bowels  29-
 —Want of Appetite  292
 —Heart-Burn        293
    CHAPTER XLV.
 Nervous Difeafes     294
 Melancholy          298
 The Palfy           301
 Tetanus,or Locked Jaw 302
 Of the Epilepfy, or Fal-
   ling-Sicknefs       304
 —Hiccup           3jg6
 —Cramp of the (Iomach307
 —Night-Mare        308
 —Swoonings         309
 —Flatulencies orWind3ii
 —Low Spirits        313
 Of Hyfteric Affections ibid.
 —Hypochondriac Affec-
   tions             316
    CHAPTER  XLVI.
 Diforders of theteenfes3i8
 —of the fl^e         319
A Gutta Serena       320
 A  Cataract          ibid.
 Short Sightednefs     ibid.
 Seeing only at too grfcat
  a Diflance         ibid.
 Squinting            ibid.
 Blood-fhot Eye       321
 Watery or weeping eye ibid.
 Of the Ear          ibid.
 —Tafle and Smell     323
 —Touch             324
   CHAPTER XLVII.
 OfaSchirrus&Cancer 325
  CHAPTER  XLVIII.
 OfPoifons           329
 —Mineral Poifons     ibid.
 —Vegetable do.      330
 Bites of Poifonous Ani-
   mals             33 j 
CONTENTS.             /
—of the Mad Dog    313
—of the Viper        336
—of;Poifonous Infects 337
   CHAPTER XLIX.
Of the Venereal Difeafe337
—Virulent Gonorrhoeas
—Gleets            342
—Swelled Tefticle    343
—Buboes           344
—Chancres          345
Confirmed Lues      348
General ObfeiJjations 351
      CHAPTOt L.
Difeafes of Women   $55
Of the Menftrual Dif-
*   charge           356
Of Pregnancy       360
—Child-Birth       362
—Barrengwtfs        368
     CHAPTER  LI.
Difeafes of Children  36q
Of the Meconium    370
—the ApthseorThrufhibid.
—Acidities          371
—Galling and Excoria-
   tion              372
—Stoppage at the Nofe 373
—Vomiting         ibid.
—a Loofenefs       374
—the Vomiting  and
   Purging of Children ^ys
—Eruptions         377
—the Hives         378
 —the Spafmodic &>. 379
—Teething          380
—the Rickets       382
—Convulfions       384
 —W?it zr in the Head, or
   Dropfy of the Brain 385
   CHAPTER LII.
Of Surgery          387
—Bleeding         ibid.
—Inflammations and
  Abfceffes          389
—Wounds          391
—Burns             393
—Bruifes            395
—Ulcers            396
    CHAPTER LIU.
Of Diflocations       397
Diflocations of the Jaw 398
—of the Neck       399
------of the Ribs   ibid.
------of the Shoulder 400
------of the  Elbow ibid.'
------of the  Wrift and
       Fingers       401
       of  th e Thigh il, i. 1.
-------of  the  Knees ibid.
-------of  the  Ancles ibid.
—-----of  the  Toes  ibid.

    CHAPTER LIV.
Of Broken Bones, &c. 401
—Strains            404
—Ruptures         ibid.
    CHAPTER LV.
Of Cafualties         406
—Subftances  ftopt be-
   tween the Mouth and
   Stomach          407
—Drowned Perfons  411
—Noxious Vapours  413
Effects of extreme C0W415
--------Heat       416
------—Drinking cold
   Water in Warm Wea-
   ther              417 
I              CONTENTS.
   CHAPTER LVI.
Of fainting Fits, & other
  Cafes which  require
  immediate Afliftance 418
-—Intoxication        42 *
—Suffocation and
  Strangling         422
—Perfons falling into
  convulfion Fits     434
   CHAPTER LV1I.
Cautions concerning cold
  Bathing and Drinking
  the Mineral Water* 426
CONTENTS OF THE APPENDIX.
Introduction         437
Lift of Simples       441

  Medical Preparations.
Balfams             443
Boluffes             ibid.
Cataplafms&Sinapifms 444
Clyfters             445
Collyria, or Eye- Waters 446
Confections          447
Conferves & Preferves ibid.
Decoctions           448
Draughts            449
Ele&uaries           45°
Emulfions           451
Extracts            451
Fomentation!        ibid.
Gargles             453
Infufions		454
Juleps		455
Mixtures		456
Ointments,	Liniments	1
Cerates		457
Pills,		459
Plaifters,	t ■*-	461
Powders »		462
Syrups,		464
Tinctures, Elixirs, &c. 465
Vinegars            468
Waters by Infufion,&c.469
Simple diftilled Waters  ib.
Spiritous diftilled do. 470
Wheys              471
Wines              ibid.
A Gloffary          473
Index               47^ 
      ADVERTISEMENT.

                        ——DgSBEJW11

   SIXTEEN years  have elapfed,  fihce the firft edition of this
    book appeared.  Daring that period, the author has taken oc-
 cafion to improve feveral articles, inferted in  the  more early im-
 preflions. For this he has been cenfured; but it would be unpar-
 donable in the writer, to-fuiFcr ap error ih a book, on which health
 and life  may depend,  to ftand  uncorrected;  or, to perceive an
 omiftion, and leavejt'pnlupplied.  His improvements  are not the
 refult of mercenary views. The fame principle which prompted
 him to write the book, wiHjever induce him to improve it, to the ut-
 moft of his  power.
   The author regrets, that  the limits of one volume preclude many
 interefting obfervations, and'likewife deprive him of the pleafure
 of inferting a number of very ufeful remarks, made by doctor
 Duplanil,  of Paris, who publifhed an elegant translation of this
 work, in five volumes octavo, with a commentary.
   The improvements of the later editions are chiefly inferted in
 the form of *iotes,  Thefe are intended either to illuftrate the text,
 or to put peopleon their guard in dangerous ficuations, and prevent
 fatal miftakes in the practice of medicine.
   Although the domestic medicine was never intended to fu-
 percede the ufe of a phyfician, but to fupply his place in fituationa
 where medical affiftance could  not eafily be obtained ; yet the au-
 thor is'forry to obferve, that the jealoulies and fears of the faculty,
 have prompted many of them to treat this  work, in  a  manner un-
 becoming the profeflbrs of liberal fcience: notwithstanding their
 injurious treatment, he is determined to perfift in his plan, being
 fully convinced of  its utility •, nor (hall intereft, or prejudice, ever
 deter him from exerting his beft endeavours  to render the  medical
 art more extenfvely beneficial to mankind.
   But this  treatment of the faculty, is not the only thing of which
 the author  has caufe to complain.  By fome of them his book has
. been  ferved up  mangled  and  mutila&ed,  and its title, type, fize,
 &c. fo clofely imitated, that  purchafers are milled, and frequently
 buy thefe fpurious  productions inftead of the real one.  That a
 needy author, incapable himfelf of producing an  original work,
 ftiould prey upon another, is a thing not at all to be wondered at:
 but that all this can be done  with  impunity, (hews, that the laws
 of this country, refpecting literary property, are (till in a very im-
 perfect ftate.
      London,
         Nov, 10,  1785:. 
PREFACE.
        WHEN I firft fignified my intention of publifhing the follow-
         ing (heets, I was told by my friends, that it  would draw
 on me the refentment of the whole faculty. 1 refolved to make the
 experiment: which came out as might have been expected. Many
 whofe learning ana liberality of fentiments do honour to medicine,
 received the book  with indulgence, and the falfky  of the opinion,
 that every phyjician nvijhes to conceal his art,• while the felfilh and
 narrow-minded, perfecute both the book  and its  author, (hewed
 the reception, however,  which this work  has met with from the
 public, merits my mod grateful acknowledgments.  As the beft way
 of expreffmg thefe, I have endeavoured to render it more general-
 ly ufeful, by enlarging that part which treats of preventing difea-
 fes ; and by adding many articles which had been entirely omitted
 in the former impreffions. It is needlefs to enumerate thefe  addi-
 tions: I  hope that they will be found real improvements.
   This v/as fo apparent, as, with me, to amount to a  proof of the
 following melancholy fail :  That almoft one half of the human
 fpecies perifli in infancy, by improper management  or neglect.  No
 one, who has not had an opportunity of obferving  them, can ima-
 gine what abfurd and ridiculous practices itill prevail  in the nurf-
 ing and management of infants, and what numbers of lives are by
 that means loft to  fociety. As thefe practices are chiefly owing to
 ignorance, it is to be hoped that when nurfes are better informed,
 their conduct will  be very different.
   The obfervations relative to nurfing and the  management of
 ehildren, were  chiefly fuggefted by an extenfive  practice among
 infants, in a large  branch of the Foundling Hofpital,  where I had
 an opportunity not only of treating the difeafes incident to child-
 hood, but likewife of trying different plans of nurfing, and of ob-
 ferving their effects. Whenever I had it in my power to place the
 ehildren  under the  care of proper nurfes, to inftruct thefe nurfes in
 their duty, and to be fatisfied that they perform it, very few of them
 died j but when,  from diftance of place,  and  other unavoidable
 circumftances, the children were left to the fole care of mercenary
 nurfes, without any perfon to inftruct or fuperintend them, fcarcc
 any of them lived.
  The application of medicine to the various occupations of life
has been, in general, the refult of obfervation.  An extenfive prac-
tice for feveral years, in one of the largeft manufacturing towns
an England, afforded me fufficient opportunities of obferving the
injuries which thofe ufeful people fuftain  from their particular
 employments, and  likewife of trying various methqds of obviating 
PREFACE.
n
^fuch injuries.  The fuccefs which attended thefe trials was fuffici-
 ent to encourage this attempt, which, I hope, w;il  be of ufe  to
 thofe who are under the neceflity of earning lht-ir bread by  fuch
 employments as are unfavourable to health.
    I do not mean  to intimidate men, far lefs to infinuate that even
 thofe arts,  the practice of which is attended with fome degree of
 danger, fhould not be carried on; but to guard the  lefs cautious
 and unwary againft thofe dangers which they have it in their pow-
 er to avoid, and  which they often, through mere ignorance, in-
 cur. As every occupation in life, difpofes thofe who  follow it,  to
 fome particular difeafes  more than to others,  it is of importance
 to know thefe, that people  may guard againft them.  It is better to
 be warned of  the approach of an enemy, than to be  furprifed  by
 him.
    The obfervations concerning diet, air, exercife, Sec. are of a
 more general  nature, and have not efcaped the attention of phyfi-
 cians in any age.  They are fubjects of too great importance, how-
 ever, to  be pafl~ed over  in an attempt of this  kind, and can never
 be fufficiently recommended. The man who pays a proper atten-
 tion to thefe, will feldom need the phyfician ; and he who does not,
 will feldom ei joy health,  let him employ as many phyficians as
 he pleafes.
    Though I have endeavoured to point out the caufes of difeafes,
 and to put people upon  their guard againft them, yet they are of-
 ten of fuch a nature, as to be removed only by the diligence and ac-
 tivity of the public magistrate. I am forry, indeed, to obferve, that
 the power of the magistrate is feldom exerted in this country for
 the  prefervation  of health. The importance of a, proper medical
 police is either not underftood, or little regarded.  Many things
 highly injurious to the public health are daily practifed with impu-
 nity, while others,  absolutely neceffary for  its prefervation, are
 entirely neglected.
    Some of the public means of preferving health are mentioned
 in the general prophylaxis, as the infpection of provifions, widen-
 ing the ftreets of great towns,  keeping them clean,  fupplyingthe
 inhabitants with wholefome water,  &c.; but they are puffed over
 in a very curfory  manner. A proper attention to thefe, would have
 fwelled this volume to too  large a fize; I have therefore referved
 them for the fubject of a future publication.
    In the treatment of diieafes, I have been peculiarly attentive to
 regimen. The generality of people lay too much ftrefs upon medi-
 cine,  and truft too little to their own endeavours. It is always in
 the power of  the patient,  or of thofe  about him, to do  as much
•"towards his recovery as can be effected by the phyfician.  By not
 attending to  this, the defigns of  medicine  are often fruftrated ;
 and the patient,  by purfuing a wrong plan of regimen,  not only
 defeats the doctor's endeavours, but renders them  dangerous. I
 have often known patients killed by an error in regimen, when 
12
PREFACE.
they were ufing very proper medicines.  It will be faid, the pny.i-
cian always orders the regimen when he prefcribes a medicine. 1
wim it were fo, both for the honour of the faculty and the fafety
of their patients :  but phyficians, as well as other people, are too
little attentive to this matter.
   Though many reckon it doubtful whether medicines are more
beneficial or hurtful to  mankind, yet all allow the  neceflify  and
importance of a proper regimen in difeafes.  Indeed, the very appe-
tites of the fick prove its propriety.  No man in his fenies ever ima-
gined that a perfon  in a fever, for  example, could eat,  drink, or
conduct himfelf in the fame manner as one in perfect health. This
part of medicine, therefore, is evidently founded in nature,  and
is confiftent' with reafon and common fenfe. Had men been more
attentive to it, and  lefs folicitous in hunting after fecret remedies,
medicine had never  become an object of ridicule.
   Indeed, this feems to have been the firft idea of medicine. The
ancient phyficians acted chiefly in the  capacity of nurfes. They
went very little beyond aliment in their prefcriptions; and even
this they generally adminiftered themfelves, attending the fick, for
that purpofe, through the whole courfe  of the difeafe ; which gave
them an opportunity not only of marking the  charts of difeafes
wkh great accuracy, but likewife of obferving the effects of their
different applications, and adapting them to the fymptoms.
   Dr. Arbuthnot afferts, that by a proper attention to thofe things,
which are almoft within the reach  of every  body, more good and
lefs.mifchief will be done in acute difeafes, than by medicines im-
properly and unfeafonably adminiftered; and that great cures may
be effected in chronical diftempers, by a proper regimen of *-he di-
et only. So entirely do the -doctor's fentiments and mine  agree,
that I would advife  every perfon, ignorant of phyfic, to confine his
practice folely to diet, and the other parts of regimen ; by which
means he maybften do  much good, and can feldom do any hurt.
   This feems alfo to have been the. opinion of Dr. Huxham, who
©bferves,  that we often feek from art what all-bountiful nature
molt readily, and as effectually,  offers us,  had we diligence and
fagacity enough to obferve and make ufe of them ; that the dietetic
part of medicine  is  not fo much ftudied as it ought to be;  and
that, though lefs pompous, yet it  is the moft natural method of
curing difeafes.
    To render the  book mere generally ufeful, however, as well as
moie acceptable to the intelligent part of mankind, I have, in moft
difeafes, befidts regimen, recommended fome of the moft fimple
ami approved forms of medicine, and added fuch cautions and di-
rections as feemed neceffary for their fafe adminiftration. It would
no doubt have b^en more acceptable to many, had it abounded
with pompous prefcriptions, and  promifed great cures in confe-
rence of their  ufe;  but this was not my plan : I think the ad*
miniflration of medicines always doubtful, and often dangerous, 
PREFACE.
'3
 and would much rather teach men how  to avoid the neceffity of
 iifing them, than how they fhould be ufed.
   Several medicines, and thofe of confiderable efficacy, may be
 adminiftered with great freedom and fafety.  Phyficians general-
 ly trifle a long time with medicines before they learn their proper
 ufe.  Many peafants at prefent know better  how to ufe fome of
 the moft important articles in the materia medica, than  phyficians
 did a century ago ;  and doubtlefs the fame obfervation will hold
 with regard to others fome time hence. Wherever I was convinced
 that medicine might be  ufed with fafety, or where the cure de-
 pended chiefly upon it, I have taken care to recommend it j  but
 where it was either highly dangerous, or not very  necefTary, it is
 omitted.
   I have not troubled the reader with an ufelefs parade of quota-
 tions from different authors ; but have, in general, adopted their
 obfervations where my own were either defective, or totally want-
 ing. Thofe to whom I am moft obliged are, R.amazini, Arbuth-
 not, and Tiffot \  the laft of which, in his Avis au Peuple, comes
 the neareft to my views of any author  which I have feen.  jHad
 his plan  been as complete  as the execution is mafterly,  we
 fhould have had no occafion for any new treatifeof this kindfoonj
 but by confining himfelf to the  acute  difeafes, he  has,  in  my
 opinion, omitted the moft ufeful part of  his fubject.  People in
 acute difeafes may fometimes be their own phyficians ;  but in the
 chronic, the cure muft ever depend chiefly upon the patient's own
 endeavours.  The doctor has alfo paffed  over the Prophlyaxis, or
 preventive part of medicine, very fligh'tly,  though it is certainly of
 the greateft importance in fuch a work.
   Several other  foreign phyficians of eminence, have  written on
 nearly the fame  plan with Tiffot, as the baron Van Swieten, phy-
 fician to their imperial magefties, M. Rofen, firft phyfician of the
 kingdom of Sweden, Sec.; but their productions have never come
 to my hand. I wifh that fome of our diftinguifhed countrymen
 would follow their example. There ftill remains much to be dpn«
 on this fubject, and no man could better  employ his time or talents
 than in eradicating hurtful prejudices, and diffufing ufeful know-
 ledge among the people.
   Some of the faculty difapprove every attempt of this nature, ima-
 gining that ic muft deftroy their influence.  But this notion appears
 to me to be as abfurd as it is illiberal.  People  in diftrefs will al-
 ways apply  for relief to, men of fuperior abilities, when they have
 it in their power ; and  they will  do this with  far greater confi-
 dence and readinefs, when they believe that medicine is a rational
 fcience, than when they take it to be only a  matter of mere con-
 jecture.                                        ;
   Though I have endeavoured to render this treatife plain and ufe-
 ful, yet I found it impoflible to avoid fome terms of art; but thofe
are, in general, either explained,  or are fuch as moft  people un- 
14            PREFACE.

derftand. In fhort, I have endeavoured to conform my ftile to the
capacities of mankind in general; and, if my readers do not flatter
either thcmfelves or me, with fome degree of fuccefs.  On a medical
fubject, this is not fo eafy a matter as fome may imagine. To make
a fhow of learning, is eafier than to write plain fenfe, efpecially in a
fcience, which has been kept at fuch a diftance from common ob-
fervation.  It would, however, be no difficult matter to prove, that
every thing valuable in the practical part of medicine, is within
the reach of common abilities.
   It would be ungenerous not to exprefs my warmed acknowledg-
ments »o thofe gentlemen, who have endeavoured to extend the ufe-
fulnefs of this performance, by tranflating it into the language of
their refpective countries.  Moft of them have not only given ele-
gant tranflations of the book, but have alfo enriched it with many
ufeful bbfervations ; by which it is rendered more complete,  and
better adapted to the climate and the conftitutions of their  country-
men. To doctor Duplanil of Paris, phyfician to the count d'Artois,
I lie under particular obligations;  as  this gentleman has  not only
cenfiderably enlarged my treatife; but, by his very ingenious and
ufeful notes, has rendered it fo popular on the continent,  as to oc-
eafion its being tranflated into all the languages of  modern Europe.
   The book has not more exceeded my expectations in its fuccefs,
than in the effects it has produced. Some  of the moft pernicious
practices,  with regard to the  treatment  of the fick, have already
given place to a more rational conduct; and many of  the moft
hurtful prejudices, which feemed to be quite insurmountable, have,
in a great meafure, yielded to better information.  Of this, a ftron-
ger inftance cannot be given,  than  the inoculation of the fmall-
pox.  Few mothers, fome years ago,  would fubmit to have their
children inoculated, even by the hand of a  phyfician ; yet nothing
is more certain, than that  of late, many of  them  have performed
this operation with their own hands;  and as their fuccefs has been
equal to that of the moft dignified inoculators, there is little rea-
fon to doubt that the practice will become general.   Whenever
this fhall be the cafe, more lives will be faved by inoculation alone,
than are at prefent by all the endeavours of the faculty. 
INTRODUCTION.
      THE improvements in medicine, fince the revival of learning,
       have not kept pace with thofe of the other arts.  The reafon
 is obvious.  Medicine has been ftudied by few,  except thofe who
 intended to live by it as a trade. Such, either from a miftaken zeal
 for the honor of medicine, or to raife their own importance, have
 endeavoured to difguife and conceal the art. Medical authors have
 generally written in a foreign language ;  and thofe who were une-
 qual to  this talk, have even valued themfelves upon couching, at
 leaft, their prefcriptions, in terms and characters, unintelligible to
 the reft of mankind.
   The contentions of the clergy, which  happened foon  after the
 reftoration of learning, engaged the attention of mankind, and pav-
 ed the way for that freedom of thought  and enquiry, which has
 fince prevailed in  moft  parts of Europe, as to religious matters.
 Every man took a fide in thofe bloody difputes ; and every gentle-
 man, that he might diftinguifh himfelf on one fide or other, was in-
 structed in  divinity. This taught people to think and reafon for
 themfelves in matters of religion, and at laft  deftroyed that com-
 pfete and abfolute dominion, which  the clergy had  obtained over
 the minds of men.
   The ftudy of law has likewife, in the moft civilized nations, beea
 juftly deemed the neceffary part of the education of a gentleman.
 Every gentleman ought certainly to know at leaft the  laws of his
 own country : And, if he were alfo acquainted with thofe of others,
 it might  be more than barely an ornament to him.
   The different branches of philofophy have alfo of late been uni-
 verfally ftudied by all who pretended to  a liberal education. The
 advantages of this are manifeft. It frees the mind from prejudice
 and fuperftition ; fits it for the inveftigation of truth; induces ha-
 bits of reafoning  and judging* properly; opens  an inexhauftible
 fource of entertainment; paves the way to the improvement of arts
 and agriculture; and qualifies men for acting with propriety in the
 moft important ftations  of life.
  Natural Hiftory is likewife become an  object of general atten-
 tion. And it well deferves to be fo. It leads to difcoveries of the
 greateft importance. Indeed, agriculture, the moft ufeful of all arts,
 is only a branch of natural hiftory, and can never arrive at a high
 degree of improvement, where the ftudy of that  fcience is ne-
glected.
  Medicine, however, has not been reckoned a neceffary part of the
education of a gentleman.  No fufficient reafon can be affigned for
this omiffion. No fcience lays open a more extenfive field of ufefid 
 16         INTRODUCTION.

knowledge, or affords more ample entertainment to an inquifitiVff
mind.  Anatomy, Botany, Chemiftry, and the Materia Medica, are
all branches of natural hiftory, and are fraught w'ith fuch amufe-
ment and utility, that the man who entirely neglects them, has but
a forry claim, either to tafte or learning.  If a gentleman has a
turn for obfervation. fays an elegant and fenfible writer*, furely
the natural hiftory of his own  fpecies is a more interefting  fub-
ject, and prefects a mora ample field for  the exertion of genius,
than the natural hiftory of fpiders and cockle-fhells.
  We  do  not mean that every man fhould  become a phyfician.
This would be an attempt as ridiculous as  it  is impoflible. All we
plead for, is, that men of" fenfe and learning, fhould  be fo far ac-
quainted with the general principles of medicine,  as to be in a con-
dition to derive from it fome of thofe advantages with which it is
fraught; and at the fame time to guard themfelves againft the def-
trudtive influences of Ignorance,  Superftition, and Quackery.
  As matters ftand at prefent, it is eafier to cheat  a man out of
his life than of a ihilling, and almoft impoflible either to detect or
puniP-i the offender. Nothwithftanding this,  people will  fhut their
eyes, and  take every thing upon tru'ft that is adminiftered by any
pretender to medicine, without daring to afk him a reafon for any
part of his conduct. Implicit faith, every where elfe the object of
ridicule, is ftiil facred here. Many of the faculty are, no doubt,
worthy1 of all the confidence that can be repofed in  them ; but as
this can never be the character of every individual in any profef-
fion, it would certainly be for the fafety, as  well as  the honour of
mankind,  to have fomt check upon the conduct of thofe to whom
they jntruft fo valuable a treafure as health.
   The veil of myftery,  which ftill han^s  over medicine, renders
it not only a conjectural, but even a fufpicious art.  This has been
 long ago removed from the other fciences, which induces many to
 believe that medicine is a mere trick, and that it will not bear a fair
 and candid examination. Mfcdicine, however, needs only to be bet-
 ter known,  in order to  fecure the general efteem of mankind. Its
 precepts are fuch, as every  wife rnan would chufe to obferve, and
 it forbids nothing, but what is incompatible with true happinefs.
   Difguifing medicine, not only retards its  improvement as a fci-
 «nce,  but expofes the profeflion to ridicule, and is injurious to the
 true interefts of fociety. An art founded on  obfervation never can
 arrive at any high degree of improvement, while it is confined to
 a few who make a trade of it. The united  obfervations of all the
 ingenious and fenfible  part of mankind, would  do  more in a few
 years towards the improvement of medicine, than thqfe of the fa-
 culty alone in a great many. Any man can tell when a medicine.
 gives him eafe, as well  as a phyfician ; and  if he onjy knows the
 name and dofe of the medicine,  and the name of the difeafe, it is

     •*  Obfervations on the  duties and offices  of a phyfician. 
INTRODUCTION.
*7
 fufficient to perpetuate the fact.  Yet the man who adds one fingle
 fact to the ftock of medical obfervations, does more real fervice to
 the art,  than he who writes a volume in fupport of fome favourite
 hypothefis.
   Very few of the valuable difcoveries in medicine have been made
 by phyficians.  They have,  in general, either been the effect of
 chance or of neceflity, and have been ufually oppofed by the facul-
 ty, till every one elfe was convinced of their  importance. An im-
 plicit faith in  the opinions of teachers,  an attachment to fyftems
 and  eftablifhed forms, and the  dread of  reflexions,  will always
 operate upon thofe who follow medicine as a trade. Few improve-
 ments are to be expected from a man who might ruin his character
 and  family by even the fmalleft deviation from an eftablifhed rule.
   If men of letters,  fays  the author of the  performance quoted
 above, were to claim their right of enquiry into a matter that fo
 nearly concerns them,  the good effects on medicine  would fooa
 appear. Such men w ould have no feparate intereft from that of the
 art.  They would detect and expofe affuming  ignorance under the
 mafic of gravity and importance, and would be the judges and pa-
 trons of modeft merit. Not having their understandings perverted
 in their youth by falfe theories, unawed by authority, and unbiaf-
 fed by intereft, they would canvafs with freedom the moft univer-
 ially received principles in medicine, and expofe the uncertainty
 of many of thole doctrines, of which a phyfician dares not fo much
 as feem to doubt.
   No argument, continues he, can be brought againft laying open
 medicine, which does not apply with equal,  if not greater force,
 to religion ; yet experience has fhown, that, fince the laity have af-
 ferted their right of enquiry into thefe fubjects, theology, confider-
 ed as a fcience,has been improved, the interefts of real religion have
 been promoted,  and the  clergy have become a more learned, a
 more ufeful, and  a more refpectable  body of men, than they ever
 were in the days of their greateft power and fplendour.
   Had other  medical writers been  as honeft as this gentleman,
 the art had been upon a very  different footing at this day.  Molt
 of them  extol the merit of thofe men,  who  brought philofophy
 out' of the fchools, and fubjected it to the rools of common fenfe.
 But they never confider that medicine, at prefent, is in nearly the
 fame fituation  as philofcphy was in at that time, and that it might
 be as much improved by being treated in the fame manner.  In-
 deed, no  fcience can cither be  rendered rational or ufeful, without
 being fubmitted  to the  common fenfe and reafon of mankind.
Thefe alone ftamp a value upon fcience ; and what will not bear
 the teft of thefe, ought to  be rejected.
  It  will be faid, that diffufing medical knowledge among the peo-
ple, might induce them to tamper with medicine, and to  truit to
ffceir own fkill inftead of  calling a phyfician.  The reverfe of this
 is true.   Perfons who have'moft knowledge in  thefe matters are
                              C 
i8
INTRODUCTION.
 commonly moft ready both to afk and to follow advice, when it ?«
 neceffary. The ignorant arc always moft apt to tamper with medi-
 cine, and have the leaft confidence in phyficians. Inftances of this
 are daily to be met with among the ignorant peafants, who, while
 they abfolutely refufe to take a medicine which has been prefcri-
 hed by a phyfician, will fwallow, with greedinefs, any thing  that
 ic recommended to them by their credulous neighbours. Where
 men will act  even with knowledge,  it is certainly  more  rational
 to afford them all the light we can, than to leave them entirely in.
 the dark.
   It may alfo be alleged, that laying medicine more open  to man-
 kind would leffen their faith in it. This would indeed be  the cafe
 with regard to fome ; but it would have a quite contrary effect upon
 others. Many people who have  the  utmoft dread and horror  of
 every thing prefcribed by a phyfician, will readily take a medicine
 which they know, and whofe qualities they are in fome meafure
 acquainted with. Hence it is evident, that the dread arifes from
 the doctor, not from  the drug.  Nothing ever  can  or will infpire
 mankind with an abfolute confidence in phyficians, but an open,
 frank, and undifguifed behaviour. While  the leaft fkadow of myf-
 tery remains in the conduct of the faculty, doubts, jealoufies, and
 fufpicions, will arife in the minds of m~n.
  Cafes will fometimes occur, where a prudent phyfician may find
it expedient to difguife a medicine. The whims and  humours of
men muft be regarded by thofe who mean to do them  fervice ; but
thjs can never affect the general argument in favour of candour and
opennefs.  A man might as well allege, becaufe there are knaves
and fools in the world, that he ought to take every one he meets
 for fuch, and  to treat him  accordingly.  A fenfible phyfician  will
 always know  where  difguife is neceffary ; but it ought never  to
 appear on the face of his general conduct.
   The appearance of myftery in the conduct of phyficians not
 only renders their art fufpicious, but lays the foundations of quack-
 ery. No two characters can be more different than  that of the ho-
 neft phyfician and the quack; yet they have been much confound-
 ed. The line  betwixt them is not fufficiently apparent ; at leaft it
 is too fine for  the general eye.  Few perfons are able to diftinguifh
 fufficiently between  the  conduct of that man who adminifters a
 fecret medicine, and him who writes a prefcription in myftical cha-
 racters and in an unknown tongue. Thus the conduct cf the honeft
 phyfician, which  needs no difguife, gives a fanction to that of the
 villain,, whofe  whole  confequence depends upon fecrecy.
  No laws will ever  be able to prevent  quackery, while people
 believe that the quack is as honeft a man, and as well  qualified  as
 the phyfician.   A very fmall degree of medical knowledge, however,
 would be fufficient to break this fpell; and nothing elfe can effec-
 tually undeceive  them.  It is the ignorance and credulity of the
 multitude, with  regard  to medicine, which render them  fuch an 
           INTRODUCTION.         j£

<eafy prey,to every one, who has the hardinefs to attack them on
this quarter. Nor can the evil be remedied by any other means but
making them wifer.
   The moft effectual way to deftroy quackery in any art or fcience,
is to diffufe the knowledge of it among mankind. Did phyficians
write their prefcriptions in the common language of the country,
and explain their intentions to the patient, as far as he-could under-
ftand them, it would enable him to know when the medicine had
the defired efTed; would infpire him with confidence in the phyfi-
cian; and make him dread  and deteft every man who pretended to
cram a fecret-medicine down his throat.
   Men, in the different ftates of fociety, have very different view?
of the fame object. Some time ago it was the practice of this coun-
try, for every perfon to fay his prayers in Latin, whether he knew
any thing of that language or not.  This conduct, though facred in
the eyes of our anceftors, appears ridiculous enough  to us ; and
Tome parts of ours will feem as ftrange to pofterity. Among thefe,
we may reckon  the prefent mode  of medical prescription, which
will fome time hence  appear to have been completely ridiculous,
and a very high burlefque upon the common fenfe of mankind.
   But this practice is not only ridiculous; it is likewife dangerous.
However capable phyficians may be of writing Latin, apothecaries
are not always in a condition to read it, and dangerous miftakes,
ra confequence of this, often happen. But fuppofe the apothecary
ever fo able to read the phyfician's prefcription, he is generally
otherwife employed, and the bufinefs of making up prefcriptions
is left entirely to the apprentice. By this means, the greateft  man
in the kingdom, even when he employs  a firft-rate phyfician, in re-
ality trufts his life in the hands of an idle boy, who has not  only
the chance of being very ignorant, but likewife giddy and carelefs.
Miftakes will fometimes happen in fpite of the greateft care ; but,
where human lives are concerned, all poffible methods ought cer-
tainly to be taken to prevent them. For this reafon, the prefcrip-
tions of phyficians, inftead  of being couched in myftical characters,
and a foreign language, ought, in my humble opinion, to be  con-
ceived in the moft plain and obvious terms imaginable.
   Diffufing medical knowledge among  the people, would not only
tend t© improve the art, and to banifh quackery, but likewife to
render medicine more  univerfally ufeful.  However long  medicine
may have been known asxa fcience,  many of its moft important
purpofes to fociety have either been overlooked, or very little at-
tended to.  The cure of difeafes is a matter of great importance ;
but the prefervation of health is ftill greater. This is the concern
of every man, and ferrety what relates to it, ought to be rendered as
plain and obvious to all as poffible. Men cannot be fufficiently on
their guard againft difeafes, who are totally ignorant of their caufes.
Nor can the legiflature, in  whofe power it is to do much more for
preferring the public health, thaa caa ever be done by the faculty 
£3
INTRODUCTION.
exert that power  with propriety, and to the greateft advantage,
without fome degree of medical knowledge.
  Indeed, men ci every occupation and condition in life, might
avail  themfelves of a degree of meijical knowledge ; as it would
teach them to  avoid  the dangers peculiar to their refpetlive fta-
tions; which is always eafier than to remove their effedts.  Medical
knowledge, inftead of being a check upon the enjoyments of life,
only teaches men how to make the moft of them.  It has indeed
been faid, that to live medically, is to live miferably : But it might
with equal propriety be faid, that to live rationally, is to live mifera-
bly.  If phyficians obtrude their own ridiculous whims upon man-
kindj or lay down rules inconfiftent with reafon or common fenfer
they will be  defpifed.  But this is not the fault of medicine.  It pro-
pofes no. rules, but fuch as  are perfectly confiftent with  the true
enjoyment of life, and conducive to the real happinefs of mankind.
  Medicine has hitherto hardly been confidered as a popular fci-
ence, but as a  branch of knowledge folely confined to a particular
fet of men, while all the reft have been taught, not only to neglect,
but even to dread and defpife it. But it will appear, upon a more
Strict examination, that no  fcience better deferves their attention,
or is more capable of being  rendered generally ufeful.
  People are told, that if they dip the leaft into medical  know-
ledge, it  will render  them  fanciful, and make them believe they
have got every difeafe of which  they  read.   This, I am fatisfied,
will feldom be the cafe with  fenfible people : and, fuppofe it were,
ihey muft foon be undeceived.  A fhort time will fhow their error,
and a little  more reading will infallibly correct it.  A fingle in-
stance will fhow the abfurdity of this notion.  A fenfible lady,
rather than read a medical performance, which would inftruct her
in the management of her children, muft leave them entirely to
the care and conduct of the moft ignorant, credulous, and ftuper-
ftitious part of the human fpecies.
  Indeed, no  part  of medicine is of more  general importance
than  that which relates to  the nurfing and management of chil-
dren.  Yet few parents pay a proper attention to it.  They leave
the fole care of their tender offspring, at the very time when care
and attention are moft neceffary, to hirelings, who are either too
carelefs to do  their duty, or too ignorant to  know  it.  More lives
are loft by the carelefinefs and inattention  of parents and nurfes,
than are  faved by  the faculty.  The joint and well-conducted en-
deavours of private  perfons and the  public, for the prefervation
of infant lives, would be of more advantage to fociety, than the
whole art of medicine, upon its prefent footing.
  The benefits of medicine, as  a  trade, will ever be confined to
thofe who are able to pay for them ; and of courfe, the far greater
part  of mankind will be every where deprived of them.   Phyfi,
cians, like other ptx'ple, muft live by  their employment, and the
poor  muft either  want advice altogether, or  take up  with  that 
INTRODUCTI ON.
which is worfe than none.   There are not, however, any where
wanting well-difpofed people, of better fenfe, who  are willing to
fupply the defect of medical advice to the poor, did not their tear
of doing  ill  often  fupprefs their inclination  to do good.  Such
people  are often deterred from  worthy actions, by  the  foolifh
alarms  founded in their ears by a fet of men, who, to Taife their
own importance, magnify the difficulties of doing good, find fault
with what is truly commendable, and  fleer at every attempt to
relieve the fick, which is not conducted by the precife rules of medi-
cine.  Thefe gentlemen muft, however, excufe me for faying, that
I have often known fuch well-difpofed perfons  do much good ; and
that their practice, which is generally the refult of good fenfe and
obfervation, aflifted by a little medical reading, is frequently more
rational, than that of the ignorant retainer to phyfic, who defpifes
both reafon and obfervation,  that he  may go wrong by rule ; and
who, while he is dofing his  patient with medicines, often neglects
other things of far greater importance.
   Many things are neceffary for the  fick, befides medicine. Nor
is the perfon who takes care to procure thofe for them, of lefs im-
portance than a phyfician. The poor  oftner perifh in difeafes, for
want of proper nurfing,  than of medicine. They are frequently in
want of even the neceflaries of life, and ft ill more fo of what is pro-
per for a fick bed: No one can imagine, who has not been a witnefs
of thefe fituations, how much good a well-difpofed perfon may do,
by only taking  care to have fuch wants fupplied.  There certainly
cannot be a more neceffary, a more noble, or a more  godlike ac-
tion, than to adminifter to  the  wants of our fellow-creatures in
diftrefs.
   Perfons who do  not chufe to adminifter medicine to the fick,
may  neverthelefs direct their regimen.  An eminent medical au-
thor has faid, that  by diet  alone all  the intentions of medicine
may be anfwered. No doubt a great many of them may; but there
are other things befide diet,  which ought by no means to be ne-
glected. Many hurtful and  deftrudtive prejudices, with regard to
the treatment of the fick, ftill prevail among the people, which
perfons of better fenfe and learning alone can eradicate.  To guard
the poor againft the influence of thefe prejudices, and to inftil in-
to their minds fome juft ideas of tl.j importance of proper food,
frefh air, cleanlinefs, and other pieces of regimen neceffary in dif-
eafes,  would be a work of great merit, and productive of many
happy confequences. A proper regimen, in  moft  difeafes, is at
leaft equal to medicine, and in many of them, it is greatly fupeiior.
   To affift the well-meant endeavours of the humane and benevo-
lent in relieving diftrefs; to eradicate dangerous and hurtful pre-
judices; to guard the  ignorant and credulous againft the frauds
and impofitions of quacks and impoftors; and to fhow men what
is in their own power, both with regard to the prevention and cure
'A difeafes, are certainly objects worthy of the phyfician's atten- 
S3        INTRODUCTION.

tion. Thefe were the leading views in compofing and publifhmg
the following meets.  They were fuggefted by an attention to  the
conduct of mankind, with regard to medicine,  in the courfe of
a pretty long practice in different parts of this ifland, during which
the author has often had occafion to wifh that  his  patients,  or
thofe about them, had been poflefled of fome fuch plain directory
for regulating their  conduct.   How far he has fucceeded in his
endeavours to fupply this deficiency, muft be  left for others to
determine ; but if they be found to contribute, in any meafure,
towards alleviating the  calamities of mankind, he will think his
labour very well beftowed. 
T* y— ■•■" --s-.....—rr •;- -■-■■ :"■-' ■■■;.......-r--r-


                      P  A R T  I.
               OF THE

General  Caufes  of Difeafes,
CHAPTER   I.
               OF   CHILDREN.

      THE better to trace difeafes from their original caufes, we (hall
       take a view of the common  treatment of mankind, in the
 ftate of infancy. In this period, the foundations of a good or bad
 conftitution are generally laid ; it is therefore of importance, that
 parents be acquainted with the various caufes  which may injure
 the health of their offspring.
   It appears from  the annual regifters of the dead, that almoft one
 half of the  children born in Britain, die under twelve years of age.
 To many, indeed,  this may appear  a natural evil, but, on due ex-
 amination, it will be found to be one of our own creating. Were
 the death of infants a natural evil, other animals would be as liable
 to die young, as man; but this we find is not the cafe.
   It may feem ftrange, that man, notwithftanding his fuperior rea-
 fon, fhould fall fo  far fliort of other animals, in the management
 of his young: But our furprife will  foon ceafe, if we confider that
 brutes, guided by  inftinct, never err in this refpect; while man,
 rrufting lblely to art, is feldom right. Were a  catalogue of thofe
 infants, who perifh annually by art alone, exhibited to public view,
 it would aftonifh moft people.
  If parents are above taking care of their children, others muft be
 employed for that purpofe: Thefe  will endeavour to recommend
 themfelves  by the  appearance of extraordinary fkili and addrefs.
 By this means fuch a number of unneceffary and deftructive arti-
 cles have been introduced into the  diet, clothing, &c. of infants,
 that it  is no wonder fo many perifh.
  Nothing can be more prepofterous than a mother who thinks it
beneath her to take care of her own child, or who is fo ignorant as
not to  know what is proper to be done for it.  If we fearch nature
throughout, we cannot find a parallel to this. Every other animal is
the nurie of its own offspring, and they thrive accordingly. Were 
24                  OF CHILDREN.

the brutes to bring up their young by proxy, they would fhare ths
fame fate with thofe of the human fpecies.
   We mean not, however, to impife it as a talk upon every mother
to fuckle her own  child.  This is in fome cafes impracticable, and
would inevitably prove destructive botli to the mother  and  child.
Women of delicate confutations, fubject to hyfteric fits, or other
nervous affections, make bad nurfes : and thefe complaints are now
fo common, that it is rare to find a woman  of fafhion  free from
them; fuch  women, therefore, fuppofing them willing, are often
unable to fuckle their own children.
   Almoft every mother would be in a.condition to give fuck, did
mankind live agreeably to nature : but whoever cortfiders how fur
many mothers  deviate from her dictates, will not be furprifed to
find fome of them unable to perform  that neceffary office. Mothers
who do not eat  a fufficient quantity of folid food, nor enjoy the be-
nefit of free air and exercife,  can neither have wholefome juices
themfelves,  nor afford proper  nourifhment to an infant : Hence
children, who are fuckled by delicate women, either die young, or
are weak and fickly all their lives.
   When we fay that mothers are not always in a condition to fuckle
their own children, we would  not be underftood as difcouragnrg
that practice. Every mother who can, ought certainly to perform
fo tender and agreeable an office*.  But, fuppofe it to be out of
her power, fhe  may, neverthelefs, be.of great fervice to her  child.
The bufinefs of nurfing, is by  no means confined to giving fuck.
To a woman who abounds with milk, this  is the eafieft part of it.
Numberlefs  other offices  are neceffary for  a child, which the mo-
ther ought at leaft to fee done.
   A mother who abandons the fruit of her womb, as foon as it is
born, to the  fole care of an hireling,  hardly deferves that name.  A
child, by being brought up under the mother's eye, not only fecures
her affection, but may reap all the advantages of a parent's care,
though it be fuckled by another.  How can a mother be better em-
ployed than  in fuperintending the nurfery ? This is at once the meft
delightful and important  office ; yet the moft trivial bufinefs  or in-
fipid amufements are  often preferred to it !  A ftrong proof both
of the bad taite and wrong education of modern females.

  4r Many advantages would arife to fociety, as  well as to individuals,
from mothers fuckling their own children. It would prevent the tempta-
tion which poor  women are hud under,  of abandoning their children to
fuckle thofe of the rich, for tiie fake of gain :  By which means, fociety
Lofes many of its moil ufeful members, and  mothers become in fome
fenfe the murderers of their own oifspring. I am fure 1 fpeak within
the tnrch, when I fay, that not one in twenty of thofe children live, who
are thus abandoned by their mothers. For this reafon, no mother fhould
be allowed to fuckle another's child, till her own  h either dead, or fit to
be weaned. A regulation of this kind would fave many lives among the
poorer fort, and, could clo no hurt to the rich, as molt women who make
good nurftT; ar-  «ule to fttcklff tw*» children in fuccejior, upon the ftme
milk. 
                    OF  CHILDREN.                  1$

  tt is indeed ttf be regretted,  that more care is not beftowed in
teaching the proper management of children to thofe whom nature
has defigned for mothers. This, inftead of being made the princi-
pal, is feldom confidered as any part of female education. Is it any
wonder, when females fo educated come to be mothers, that  they
mould be quite ignorant of the duties belonging to that character r
However ftrange it may appear, it is certainly true, that many mo-
thers, and thofe of fafhion too, are as ignorant,  when they have
brought a child into the world, of what is to be done for it, as the
infant itfelf. Indeed, the moft ignorant of the fex are generally rec-
koned moft  knowing in the b**fmefs of  nurfing. Hence,  fenfible
people become the dupes of  ignorance and fuperftition ;  and the
nurfing  of children, inftead of being conducted by reafon, is the
refult of whim and caprice*.
  Were the time that is generally fpent by females, in the acquifi-
tion of trifling accomplifhments, employed in learning how to bring
up their children ; how to drefs them fo, as not to hurt, cramp, or
confine  their motions; how to feed them with wholefome and nou-
rifhing food; how to exercife their tender bodies, fo as beft to pro-
mote their growth and ftiength :  Were* thefe made the objects of
female inftruction, mankind would derive the greateft advantages?
from it. But while the education of females, implies little more,
than what relates to drefs and public fhow, we have nothing to ex-
pect from them, but ignorance, even in the molt important concerns*
  Did mothers reflect on their own importance, and lay it to heart,
they would embrace every opportunity of informing themfelves of
the duties, which they owe to their infant offspring.* It is their pro-
vince, not only to form the body, but alfo to give the mind its moft
early bias. They have it very much in their power, to make  men
healthy  or valetudinary, ufeful in life, or the pefts of  fociety.
  But the mother is not the only perfon concerned in the manage-
ment of children.  The father has an equal intereft in their welfare,
and ought ro affift in every thing that refpedts either the improve-
ment of the body or mind.
  It is a pity that the men fhould be fo inattentive to this matter*
Their negligence is one reafon why females know fo little of it,
"Women will ever be defirous to excel in fuch accomplifhments as
recommend them to the other fex.  But men generally keep at  fuch
a diftance from even the fmalleft acquaintance with the affairs of
the nurfery, that many would reckon  it an affront, were they fup-

  •X- Tacitus, th? celebrated Roman hiftcrian, complains greatly afther
degeneracy of the Roman ladies in his time, with regard td the care of
their offspring.  He fays, that, in former times, the greateft women in
Rome ufed to account it their chief glory to keep the houfeand attend
their children;  but that now the young infant was committed to the fole
care of fome poor Grecian wench, or other menial fervant. We are
afraid, wherever luxury and effeminacy prevail, there will be too much
ground for this complaint.
                               D 
 £6                 OF  CHILDREN.

 pofed to know any thing of them. Not fo, however, with the ken-
 nel or the {tables : A gentleman of the firft rank is not afhamed to
 give directions concerning the management of his dogs or horfes,
. yet would blufh, were he furprifed in performing the fame office
 for that being, who derived its exiftence from himfelf, who is the
 heir of his fortunes, and the future hope of his country.
   ,Nor have phyficians themfelves been fufficiently attentive to the
 management of children: This has been generally confidered as the
 fole province of old women, while men of the firft character inphy-
 fic, have refufed to vifit infants, even when fick. Such conduct in
 the faculty, has not only caufed thg$ branch of medicine to be ne-
 glected, but has alfo encouraged the other fex to aflume an abfolute
 title to prefcribe for children,  in the  moft dangerous difeafes.  The
 confequence is, that a phyfician is feldom called, till the good wo-
 men have exhaufted all their fkill;  when his attendance can only
 •ferve to divide the blame, and appeafe the difconfolate parents.
   Nurfes fhould do all in their power to prevent difeafes; but when
 a child is taken ill, fome perfon of fkill ought immediately to be
 confulted. The difeafes oi children are generally acute, and the
 leaft delay is dangerous.
   Were phyficians more attentive to the difeafes of infants, they
 would not only be better qualified to treat them properly when fick,
 but likewife to give ufeful directions for their management, when
 well. The difeafes of children are by no means fo difficult to be un-
 derftood as many imagine.  It is true, children  cannot tell their
 complaints; but the caufes of them may be pretty certainly difco-
 vered,  by obferving the fymptoms, and putting proper queftions to
 the nurfes.  Befides, the difeafes of infants, being lefs  complicated,
 are eafier cured than thofe of adults*.
                Of  Difeafed'  Parents,

    ONE great fource cf the-difeafes of children is, the unhealthi-
 nefs of parents. It would be as reafonable to expect a rich crop
 from a barren foil, as that ftrong and  healthy children fhould be
 born of parents, whofe conftkutions have been worn out w ith in-
 temperance or difeafe.
    Rouffeau obferves, that on the conftitution of mothers depends
 originally that of their offspring. No one who believes this, will be
 furprifed, on a view of the female world, to find difeafes and death
 fo frequent among children. A delicate female, brought up within

    •Jfr The common opinion, that the difeafes of infants are hard to difco-
 ver, and difficult to cure, has deterred many phyficians from paying that
, attention to them which they deferve—I can, however, from experience
 declare, that this opinion is without foundation, and that (hey are nei-
 ther fo difficult to  difcover, nor fo ill to  cure,  as thofe of adulu. 
OF   CHILDREN.
27
 doors, an utter ftranger to exercife and open "air, who lives on tea
 und other flops, may bring a child into the world, but it will hardly
 be fit to live. The firft blaft of difeafe  will nip the tender plant in
 the bud :  Or, fhould it ftruggle through  a few years exiftence, its
' feeble frame, fhaken with convulfions from every trivial caufe, will
 be unable to perform the common functions of life, and  prove a
 burden to fociety.
   If, to the delicacy of mothers, we add the irregular lives of fa-
 thers, we fhall fee further caufe to believe, that children are often
 hurt by the conftitution of their parents. A fickly frame may be
 originally induced by hardfhips or intemperance, but chiefly by the
 latter.  It is impoflible that a courfe of vice fhould not fpoil the beft
 conftitution: and, did the evil terminate here, it would be a juftpu-
 nifhment for the folly of  the fufferer ;  but when once a difeafe is
 contracted and  rivetted  in the habit,  it is entailed on pofterity.
 What a dreadful inheritance is the gout, the feurvy, or the king's
 evil, to tranfmit to our offspring ! How happy had it been for the
 heir of many a great eftate,  had he been born a  beggar, rather
 than to inherit his  father's fortunes at the  expenfe of inheriting,
 his difeafes !■
   No perfon who  labours under any  incurable malady ought to
 marry. He thereby not only fhortens his own  life, but tranfmits
 mifery to others:  but when both parties are deeply tainted with
 the fcrophula, the  feurvy, or the like, the effects muft be  ftill
 worfe.  If fuch  have any iffue, they  muft  be miferable  indeed.
 Want of attention to thefe things, in forming connexions  for life,
 has rooted out more families than plague, famine,  or the fword ;
 ami as longas thefe connexions are formed from mercenary views,
 the evil will be continued •■..
   In our matrimonial contracts* it  is  amazing fo little regard is
 had to  the health and form of the object. Our fportfmen know,
 that the generous courfer cannot be  bred  out of  the foundered
 jade, nor the fagacious fpaniel  out  of the  fnarling cur.  This is
 fettled  upon immutable laws.  The man  who marries a woman of
 a fickly conftitution,. and defcended of unhealthy parents, what-
 ever his views may be,  cannot be faid to act a prudent part.  A
 difeafed woman  may prove fertile ;  fhould  this be  the cafe,  the
 family  muft become an infirmary:  what profpect of happinefs
 the father of fuch a family has, we fhall leave any one to  judgef.

   •3f The Lacedemonians condemned their king Archidamus, for having
 married a weatc, puny woman ; becaufe, faid they, inftead of propa-
 gating a race of  heroes, you will fill the throne  with a progeny of
 changelings.
   t The Jews, by their laws, were, in certain cafes, forbid  to have
 any manner of commerce  with the difeafed; and indeed to this all
 wife legiflators ought to have a fpecial  regard.  In fome countries, dif-
 eafed perfons have actually been forbid to marry.  This is an evil, of a
 complicated kind,  a  natural deformity,  and political mifchiefj and
 therefore requires a public conliderauon, 
*8
OF  CHILDREN.
  Such children as  have the  misfortune to be born of difeafed
parents, require to be nurfed with greater care than others.  This
is the only way to make amends for the defects of conftitution ;
and  it will often go a great length.  A healthy nurfe, wholefome
air, and fufficient exercife, will do wonders. But when thefe are
neglefted,  little is to be expeded from any other quarter. The
defects of conftitution cannot be fupplied by medicine.
  Thofe who inherit any famiiy-difeafe  ought to be very circum-
fpedt in  their  manner of  living.  They fhould confider well the
nature of fuch difeafe, and guard againft it by a proper regimen.
It is  certain, that family difeafes, have often, by proper care, been
kept off for  one generation; and there  is reafon to believe, that
by perfifting in the fame courfe, fuch difeafes might at length be
wholly eradicated, i his is a fubject very little  regarded, though
of the greateft importance. Family-conftitutions are as capable
of improvement  as  family-eftates ; and the libertine, who im-
pares the one, does greater injury to his  pofterity, than the prodi-
gal, who fquanders away the other.
           Of the Clothing of Children.

  THE clothing of an infant, is fo fimple a matter, that.it is fur-
prifing how any perfon fhould err in it;  yet many children lofe
their lives, and others are deformed, by inattention to this article,
  Nature knows no ufeof clothes to an infant but to keep it warm.
AH that is neceffary for this purpofe, is to wrap it in a foft loofe
covering. Were a mother left to the  dictates of nature alone, (he
would certainly purfue this courfe. But the bufinefs of dreffing an
infant has long been out of the  hands of mothers, and has at laft
become a fecret, which none but adepts pretend to undcrftand.
  From the moft early ages it has been thought neceffary, that a
woman in labour, fhould have fome perfon to attend her. This, in
time, became a bufinefs; and, as in all others, thofe who were em-
ployed in it, ftrove  to out-do one-another in the different branches
of their profeffion. The dreffing of  a child came of courfe to be
confidered  as  the midwife's province, who, no doubt imagined,
that the more dexterity fhe could fhow in this article, the more
her fkill would be  admired.  Her attempts were feconded by the
vanity of parents, who, too often defirous of making a fhow of the
infant as foon as it was born, were ambitious to have as much finery
heaped upon it as poffible. Thus, it came to be thought as neceffary
for a midwife to excel  in bracing and dreffing an infant,  as for a
furgeon to be expert in applying bandages to a broken limb; and the
poor child, as foon as it came into the world, had as many rollers
and wrappers applied to its body, as if every bone had been fractur* 
                    OF  CHILDREN.                  29

td in the birth; while thefe  were often fo tight, as not only to
gall and  wound its tender frame, but even to obftrudt the motion
of the heart, lungs, and other organs neceffary for life.
  In moft parts of Britain, the practice of rolling children, with fo
many bandages, is now, in fome meafure, laid afide; but it would
ftill be a difficult talk to purfuade the generality ofmankind, that
the  fhape of an infant does not entirely depend  on the midwife.
So far, however, arc all her endeavours to mend the fhape, from
being fuccefsful, that they conftantly operate the contrary way, and
mankind become  deformed juft in proportion to  the means ufed
to prevent it. How little deformity of body is to be found among
uncivilized nations ? So little indeed, that it is vulgarly believed,
they put all their deformed children  to death. The truth is, they
hardly know fuch a thing as a deformed child. Neither fhould we,
if we followed their example.  Savage nations never think of mana-
cling their children.  They allow them the full ufe  of every organ,
carry them abroad in the open air, wafh their bodies daily in cold
water, &c. By this management, their children become fb ftrong
and hardy, that,by the time our puny infants get out of the nurfe's
arms, their's are able to  flnft for themfelves*.
  Among brute animals, no art is neceffary to procure a fine fhape.
Though  many of them are extremely delicate when they come in-
to the world, yet  we never find them grow crooked for want of
fwaddling bands.   Is nature  lefs  generous to the  human  kind?
No:  but we take the bufinefs out of nature's hands.
  Not only the analogy of other animals, but the very feelings of
infants tell us, they ought to  be kept eafy and free from all pref-
fure.  They cannot indeed tell their complaints ; but they can fhow
figns of pain; and this they never fail to do, by crying, when hurt
by their clothes. No fooner are they freed from their bracings, than
they feem pleafed and happy; yet, ftrange infatuation! the moment
they hold tneir peace, they are again committed to their chains.
  If we confider the body of an infant as a bundle of foft pipes,
replenifhed with fluids in continual motion, the danger of preffure
will  appear in the ftrongeft light.  Nature, in order to make way
for the growth of children, has formed their bodies foft and flexi-
ble ;  and left they fhould  receive any injury from preffure  in the
womb, has furrounded the foetus every where with fluids. This
fhows the care which nature takes, to prevent all unequal preffure
on the bodies of infants, and to defend them againft every thing
that  might in the leaft cramp or confine their motions.
  Even the bones  of an infant are fo foft and cartilaginous, that
they  readily yield  to the flighted preffure, and eafily affume a bad

  -X-  A friend of mine, who was feveral years on the  coaft of  Africa,
tells me, that the natives neither put any clothes upon their children,
nor apply to their bodies bandages  of any kind, but lay them  on a
pallet, and fuffer them to tumble about at pleafure ; yet they are all
Jtrait; and feldom have any difeafe. 
3d                of  children:
fhape,  which can never after be remedied.  Hence it is, that fo
many people appear with high fhoulders, crooked fpines, and flat
breafts, who were as well proportioned at their birth  as others,
but had the  misfortune to be fqueezed out of fhape by the appli-
cation  of ftays and bandages.
  Preffure, by obftructing the circulation, likewife preventr. the
equal distribution of nourifhment to the different parts of the bo-
dy, by which means the growth becomes unequal.  One part grows
too large, while another remains too fmall; and thus in time the
whole  frame becomes difproportioned and misihapen. To this we
muft add, that when a child  is cramped in  its clothes,  it naturally
fhrinks from the part that is  hurt; and, by putting its body into un-
natural poftures, it becomes deformed by habit.
  Deformity of body, may indeed proceed from weaknefs or dif-
eafe ; but in general, it is  the effect of improper clothing. Nine
tenths, at leaft, of the deformity among mankind, muft be  imputed
to this  caufe. A deformed body is not only difagreeable to the eye,
but by a bad figure, both the animal and vital functions muft be
impeded, and of courfe health impaired. Hence few people remark-
ably misihapen are ftrong or healthy.
  The new motions which  commence at the birth, as the circula-
tion of the whole mafs of blood through the lungs, refpiration, the
periftaltic motion, &c. afford another ftrong argument for keeping
the body of an infant free from all preffure.  Thefe organs not hav-
ing been accuftomed to move, are eafily flopped ; but when  this
happens, death muft enfue.  Hardly any method could be devifed
more effectually to flop thefe motions, than bracing the body too
tight with rollers* and bandages. Were thefe to be applied in the
fame manner to the body of an adult, for an equal length  of time,
they could  hardly fail to hurt the digeftion, and make him fick.
How much  more hurtful they muft prove to the tender bodies of
infants, we  fhali leave any one to judge.
  Whoever confiders  thefe things, will not be  furprifed, that fi>
many children die of convulfions foon after the  birth. Thefe fits
are generally attributed to fome inward caufe ;  but  in fact, they
oftener proceed from our own imprudent conduct. I have known
a child feized with convulfion-fits foon  after  the  midwife  had
donefwaddlingit, who, upon taking tiff the rollers and bandages,
was  immediately relieved, and never had the difeafe afterwards!
Numerous examples  of this might be given, were they neceffary!
  It would  be fafer to fix on the clothes of an infant with firings
than pins^ as thefe often gall and  irritate their tender fkins, and
occafion diforders. Pins have been found flicking above ha'lf an
inch into the body of  a child, after it had died  of convulfion  fits  '
which, in all probability, proceeded from that caufe.            *

  *  Th'.s is by no means inveighing againft a thing that does not han-
pen.  Ir   :-v parts ot Britain, at this day, a roller, eight or ten  feet
an len-::., ., yp-.lied tightly round the chiM's body as foon as it is born 
OF  CHILDREN.
3*
  Children are not only hurt by the tightness of their clothes, but
alfo by the quantity.  Every child has fome degree of fever after
the birth*;  and if  it be  loaded with  too many clothes, the fever
muft be increafed. But this is not all; the child is generally laid in
bed with  the mother, who is  often likewife feverifh ; to which
we may  add the heat of the bed-chamber, the wines, and other
heating things, too frequently given to children, immediately after
the birth.  When  all theil- ;:re combined,  which does not feldom
happen, they muft increafe the fever to fuch a degree, as will en-
danger the life of the infant.
   The danger of keeping infants'too hot will further appear, if we
confider, that after they have been for fometime in  the fituation
mentioned above, they are often fent into the country to be nurfed
ia a cold houfe.  Is it any wonder,  if a child, from fuch'a tranfi-
tion, catches a mortal cold, or contracts fome other fatal difeafe?
When an infant is kept too hot, its lungs, not being fufficiently
expanded, are apt to remain weak and  flaccid for life ; hence pro-
ceed coughs, cenfumptions, and other  difeafes; of the breaft.
   It would anfvver little purpofe, to fpecify the .particular pieces
of drefs, proper for an infant. Thefe will always vary in different
countries, according to cuftom and  the humour of parents. The
■great rule to be oblerved is, that a child have no more clothes than
;:re neceffary to keep  it warm,  and that they be quite eafy for its
body.
   Stays are the very bane of infants. A volume would not fuffice
to point out all the bad effects of this ridiculous piece of  drefs,
both on children  and adults.  The  madnefs in favour of flays,
feems however, to be fome what abated; and it is to be hoped that
the world will,  in time, become  wife enough to know,  that the
human fhape does not folely depend upon whale-bone and bend-
leather*.
   The  clothes of  children ought to  be  kept  thoroughly  clean.
Children perfpire more than adults; and  if their clothes be not
frequently changed, they become very hurtful.  Dirty clothes not
only fret and gall  the tender fkins of infants, but likevife occafioa
ill fmells ; and what is worfe,  tend to produce vermin and cuta-
neous difeafes.
   Cleanlinefs is not only agreeable to the eye, but tends greatly
to preferve the health of children.  It  promotes the perfpiration,
and by that means, frees the  body from fuperfluous humours,

  * Stays made of bend-leather, are worn by all the women of lower
ftation/m many parts of England.
  There  are (till mothers  mad  enough, to lace the'r daughter.", very
tight, in order to improve their fhape.  As reafoning v.ouid be  totally
loft upon fuch people, I fhaflrbeg leave, juft to afk them,  Why there
are ten deformed women for one  man? and likewife, to recommend to-
their perufal, a fhort moral precept, which forbid.; us to «i.eform,the L:.i-
man body. 
~2                OF  CHILDREN.

which, if retained, could not fail to occafion difeafes. No mother
or nurfe can have any excufe for allowing a child to be dirty.  1 o-
vefty may oblige her to give it coarfe clothes; but if (h« does not
keep them clean, it mult be her own fault.
            Of the Food of Children.

  NATURE not only points out, the proper food  for an infant,
but a&ually prepares it. This does  not prevent fome, who think
themfelves wifer than nature,  from attempting to bring up their
children, without her proviiion.  Nothing can fhow the difpolition
which mankind have to depart from nature, more,  than their en-
deavouring to bring up children without the breaft.  The mother's
milk, or that of a healthy nurfe, is unqueftioinbly the beft food
for an infant.  Neither art nor nature^can afford a  proper fubfti-
tute for it.  Children may feem to tlvrive for a few months with-
out the breaft; but when teething, the fm all-pox', and other difeafe?,
incident to childhood, come on, they generally perifh.
  A child, foon after birth, fhows an inclination to fuck ; and it
fhould be gratified.  The mother's milk does not always come im-
mediately after the birth;  but this is the way to bring it: Befides,
the firft milk that the child can fqueeze out of the breaft, anfwers
the purpofe of cleanfing, better than all the drugs in the apotheca-
ry's fhop,and at the fame time prevents infiammations of the breaft,
fevers, and other difeafes incident to mothers.
  It is ftrange how people came to  think, that the firft thing given
to a child,  fhould be drugs. This  is beginning with medicine by
times, and no wonder, if they generally end with it. It fometimes
happens, indeed, that the child does not difcharge the meconium
fo foon as  could be wifhed ; this has induced phyficians, in fuch
cafes, to give fomething of an opening nature, to cleanfe the firft
paffages. Midwives have improved upon this hint, and never fail
to jjjve fyrups, oils, &c. whether they be neceffary or not. Cram-
ming an infant with fuch indigeftible fluff, as foon as it is born,
can hardly fail to make it fick, and is more likely to occafion dif-
eafes, than to prevent them.  Children are feldom long after the
birth without  having paffagd both by ftool and  urine ;  though
thefe evacuations may be wanting for fome time, without danger.
 But if  children muft have fomething before they  be allowed the
 breaft, let  it be a little thin water-pap, to which may be added an
 equal quantity of new milk;  or rather water alone, with the addi-
 tion of a little raw fugar.  If this be given  without any wines or
 fpiceries, it will neither heat the blqpd,  load the ftomach, nor oc-
 cafion gripes.
    Upon the firft fight of an infant* almoft every perfon is ftruek
 with the idea of its being weak, feeble, and wanting fupport. This 
OF  CHILDREN.
3.3
f'uggefts the need of cdrdials.  Accordingly, wines are univerfally
mixed with the firft food of children.  Nothing can be more falla-
cious than this way of reafoning, or more hurtful to  infarits than
the conduct founded upon it. Children require very little food for
fome time after the birth;  and what they receive fhould be thin,
weak, light, and of a  cooling quality.  A  very fmall  quantity of
wine is fufficient to heat and inflame the blood of an  infant; but
every perfon converfant in thefe matters, muft know,  that moft of
the difeafes of infants proceed  from the heat of their  humours.
   If the mother or nurfe has enough of milk, the child will need
little or no other food, before the third or fourth month. It will
then be proper to give it, once or twice a day, a little of fome food,
that is eafy of digeftion, as  water-pap, milk-pottage,  weak brorh,
with bread in it, and  fuch like. This will eafe the mother, will
accuftom  the child by degrees  to take food, and will render the
weaning both lefs difficult and lefs dangerous.  All great and fud-
den tranfitions are to be avoided  in nurfing. For this  purpofe, the
food of children ought not only  to be fimple, but to  refemble, as
nearly as  poffible, the properties of  milk*. Indeed, milk  itfelf,
fhould make a principal part of their food, not only  before they
are weaned, but for a long  time  after.
   Next to milk, we would recommend good light bread. Bread
may be given to a child as foon as it fhows  an inclination to chew;
and it may at all times be allowed as much plain bread, as it will
eat.   The very chewing of  bread will promote the cutting of the
teeth, and the difcharge of faliva, while by mixing with the nuxfe's
milk in the ftomach, it will afford an excellent nourifhment.  Chil-
dren difcover an early  inclination  to  chew whatever is put into
their hands. Parents obferve the inclination, but generally miftake
the object. Inftead of  giving the child fomething, which may at
once exercife its gums and  afford it nourifhment, they commonly
put into its hands apiece of hard metal, or impenetrable coral. A
cruft of bread is the beft gum-flick.  It anfwers the purpofe better
than any thing elfe, and has the additional properties of nourifhing
the child,  and carrying the  faliva down to the ftomach, which is
too valuable a liquor to be loft.                             '
   Bread, befides being ufed dry,  may be many ways prepared in-
to food for children. One of the beft methods is to boil it in water,
afterwards pouring the water  off, and mixing with  the bread, a
proper quantity of new milk unboiled. Milk is both more whole-
fome and  nourifhing this way than boiled,  and is lefs  apt to occa-
fion coftivenefs. For a child farther advanced, bread may be mixed
in veal or chicken broth, made into puddings, or the like. Bread is
a proper food for children at all times, provided it be  plain, made


   ■5f  A mixture of one-fourth milk, and three-fourths barley-water,
with the addition of fome ioaf-fugar, is a good fubftituce for the milk of
the mother.   (I. C.)
                               E 
34                 OF  CHILDREN.

of wholefome grain, and well fermented; but when enriched with
fruits, fugars, or fuch things, it becomes very unwholefome.
 It is foon enough to allow children animal food, when they have
got teeth to eat  it.  They fhould never tafte it till after they are
weaned, and even then  they Ought  to ufe it fparingly. Indeed,
when children live wholly on vegetable food, it is apt to  four their
ftomachs; but on the other hand, too much flefh heats the body,
and occafions fevers and other inflammatory difeafes.  This plainly
points out a  due mixture of animal and vegetable food, as the moft
proper for children.
  Few things prove more hurtful to infants, than the common me-
thod of fweetening their food.  It entices them to take more than
they ought to, which makes them grow fat and bloated.  It is pret-
ty certain, if the food of children were quite plain, that they would
never take more than enough.  Their excefies are  entirely owing
to nurfes.  If a child be gorged with food at all hours, and  enticed
to take it, by making it fweet and agreeable to the palate, is it any
wonder, that fuch a child fhould in time be induced to crave more
food than it  ought to have ?
  Children may  be hurt by too little as well as too much food*.
After a child is weaned, it ought to be fed four or five times a day;.
but fhould never be accuftomed to eat-in the night; neither fhould
it have too much at a time. Children thrive beft with fmall quanti-
ties of food frequently given. This neither overloads  the ftomaGh,
nor hurts the digeftion,  and is  certainly moft agreeable  to nature.
  Writers on nurfing have inveighed^ with fuch vehemence agahift
giving children too much food, that  many parents, by endeavour-
ing to fliun that error, have run into  the oppofite extreme,  and ru-
ined the conftitutions of their children. But the error of pinching
children in their food is more hurtful than the other extreme. Na-
ture has many v/ays  of relieving herfelf when overcharged ; but
a child, who is pinched with hunger, will never become a ftrong-
or healthy man. That errors are frequently committed on both
fides, we are  ready to acknowledge; but where one child is hurt
by the quantity of its food, ten fuffer from, the quality. This  is the
principal evil, and claims our ftritteft attention.
   Many people  imagine that the food they themfelves love, can-
not be bad  for their children : but this notion is very abfurd.  In
the more advanced periods of life, we often acquire an inclination
for food, which,when children, we could not endure. Befides, ma-
ny things  may by habit, agree very well with the  ftomach of a
grown perfon, which would be hurtful to  a child ; as high-feafon-
ed, falted, and fmoke-dried provifions, &c. h would alfo be im-
proper to feed children with fat meat, ftrong broaths, rich foups
or the like.                                               e  '

  * They fhould be indulged in eating,  cs long as they eat with avidity •
but as foon as that has fublided, the food fhould be withdrawn, or thev
will be apt to overload their  ftomachs. (I.  C.)                    * 
OF  CHILDREN.
35
    All ftrong liquors are hurtful to children.  Some parents teach
 their children to guzzle ale, and other fermented liquors, at every
 meal. Such a practice  cannot fail to  do mifchief. Thefe children'
 feldom  efcape the violence of the fmall-pox, meafies, hooping-
 cough, or fome inflammatory diforder.  Milk, water, butter-milk,
 or whey, are the moft  proper for children to drink. If they have
 any thing ftronger, it may be fine fmall beer, or a little wine mix-
 ed with water. The ftomachs of children can digeft well enough,
 without the affiftance of warm ftimulants: Befides, being naturally
 hot,  they are eafily hurt by every thing of a heating quality.
    Few things  are  more hurtful  to  children than unripe  fruits.
 They weaken the powers of digeftion, and four and relax the fto-
 mach, by which means it becomes a proper neft for infects.  Chil-
 dren fhow a great inclination for fruit, and I believe, that if good
 ripe fruit were allowed  them in proper quantity, it would have no
 bad effects.  We never find a natural inclination wrong, if proper-
 ly regulated. Fruits are generally of a cooling nature, and correct
 the heat and acrimony of the humours. This is what moft children
 require; only care fhould be taken left they exceed.  The beft way
 to prevent children from going to excefs in the ufe of fruit, or eat-
 ing that which is bad, is to allow them a proper quantity of what is
 good*.                                        v
   Roots  which contain  a crude vifcid juice fhould be fparingly
 given to  children.  They fill the body  with grofs humours, and
 tend  to produce eruptive difeafes. This caution  is peculiarly ne-
 ceffary for the poor ; glad to obtain at a fmall price, what will  fill
 the bellies of their children, they fluff them two or  three times a
 day, with greafy potatoes, or other crude vegetables.  Children had
 better eat a fmaller quantity of food, which yields a  wholefome nou-
 rifhment, than be crammed  with what their digeftive powers are
 unable properly to affimiiate.
   Butter ought likewife to be fparingly given to children. It both
 relaxes the  ftomach,  and produces grofs humours. Moft things
 that are fat or oily, have this effect. Butter, when faked, becomes
 ftill more hurtful. Inftead of butter, fo liberally given to children
 in moft parts of Britain, we would recommend honey.  Honey is
 not only wholefome, but cooling, cleanfing, and tends to fweeten
 the humours. Children  who eat honey, are feldom troubled  with
 worms : They are alfo lefs fubject to  cutaneous difeafes, as  itch,
 fcabbed-head, Sec.
   Many people err, in thinking that the diet of children ought to
 be altogether moid.  When children live entirely upon flops, it re<-

  ¥• Children are always  fickly in the fruit-feafon, which may be thus
 a counted for : Two-thirds of the fruit which comes  to market in this
 country, is really unripe; and children not being in a condition to judge
for themfelves, eat whatever they lay their hands upon, which often
proves little better than a  poifbn for their tender bowels. Servants and
others who have the care  of children, fhould be ftriftly forbid to give
them any f.-nit wirhcut the knowledge  of their parent*, 
36                 OF  CHILDREN.

laxes their  folids, renders them weak, and difpofes  them to the
rickets,  the fcrophula, and other glandular diforders.  Relaxation
is one of the moft general caufes of the difeafes of children. Every
thing therefore which tends to unbrace their folids, ought to be
carefully avoided.
   We would not be underftood by thefe obfervations, as confining
children to any particular  kind of food.  Their diet may be  fre-
quently varied, provided always,  that fufficient regard be had to-
fimplicity.
           Of the  Exercife of Children.

  OF all the caufes which confpire to render the life of man fhort
and miferable, none has greater influence than the want of proper
exercife ;  healthy parents, wholefome food, and proper clothing,
will  avail little, where exercife is  neglected.  Sufficient exercife
will make up for feveral defects in nurfing ; but nothing can fup-
ply the want of it. It is  abfolutely neceffary to the health, the
growth, and the ftrength of children.
  The defire of exercife is coeval with life itfelf.  Were this prin-
ciple attended  to, many difeafes might be prevented.  But, while
indolence  and fedentary employments prevent two-thirds of man-
kind from either taking fufficient exercife themfelves,  or giving it
to their children, what have we to  expect, but difeafes and de-
formity among their offspring ?  The rickets,  fo deftructive to
children, never appeared in Britain, till manufactures began to
flourifh, and people, attracted by the love of gain, left the country
to follow  fedentary employments in great towns. It is  amonglt
thefe people that this difeafe chiefly prevails, and not only deforms,
but kills many of their offspring.
  The condudt of  other young animals, fhows  the propriety of
giving exercife  to children. Every other animal makes ufe of its
organs of motion as foon as it can, and many of them, even when
under no neceffity of moving in queft of food, cannot  be reftrain-
ed without force. This is evidently the cafe with the calf, the lamb,
and moft  other young animals.  If thefe creatures were not per-
mitted to  frifk about and take exercife, they would foon die or be-
come difeafed.  The fame inclination appears very early in the hu-
man fpecies ; but as they are not able to take exercife themfelves,
it is the bufinefs of  their parents and nurfes to help them.
  Children may be exercifed various ways. The beft method while
they are light, is to carry them  about in the nurfe's arms*.  This
gives  the  nurfe zn opportunity of talking to the chiid, and of

  * The nurfe ought to be careful to keep the child in a proper 'v>fif1(111.
a* deformity is often the conference of inattention to this circumiVnce! 
OF  CHILDREN.
37
 pointing out every thing, that may pleafe  and delight its fancy.
 Befides, it is much fafer than fwinging an infant in a machine, Or
 leaving it to the care of fuch as are not  fit to take care of them-
 felves. Nothing can be more abfurd than to fet one child to keep
 another : This conduct has proved fatal to many infants, and has
 rendered others miferable for life.
   When children begin to walk, the fafeft and beft method of
 leading them about,  is by the hands. The common way, of fwing-
 ing them in leading-firings fixed to their  backs, has feveral br-J
 confequences. It  makes  them throw their bodies forward,  ad
 prefs with their whole weight upon the  ftomach and breaft ;  by
 this means, the breathing is obftructed, the breaft flattened,  and
 the bowels compreffed; which muft hurt the digeftion, and occa-
 fion confumptions of the lungs and other difeafes.
   It is a common notion, that  if children  be fet upon  their feet
 too foon, their legs will become crooked. There is reafon to be-
 lieve, that the very reverfe of this is true. Every member acquires
 ftren^th, in proportion as it  is exercifed. The limbs  of children
 are weak indeed,  but their bodies  are proportionally light;  and
 had they fkill to direct themfelves, they would foon be able to fup-
 port their own weight. Whoever heard of  any other animal that
 became crooked by ufing its legs too foon  ? Indeed, if a child be
 not permitted  to make any ufe of its legs till a confiderable time
 after the birth, and be then fet upon them with its whole weight
 at once, theremay  be fome danger; but this proceeds entirely from
 the child's not having been  accuftomed  to ufe its legs  from the
 beginning.
   Mothers of the poorer fort think that they are great gainers by
 making their children lie or fit while  they themfelves work.  In
 this they are greatly  miftaken. By neglecting to give their chil-
 dren  exercife, they  are obliged  to  keep  them  a  long-time before
 they can do any thing for themfelves, and to fpend more on medi-
cine than would have paid for proper care.
   To take care of their children,  is the moft ufeful bufinefs in
 which even the poor can be employed:  But, alas! it is not always
in their power. Poverty  often obliges them to neglect  their off-
fpring, in order to procure  the neceffaries of life. When this is
the cafe, it becomes the intereft as well as  the duty of the public
to affift  them.  Ten thoufand times more benefit would  accrue to
the ftate, by enabling the poor to bring up their own  children,
than from all the hofpitals* th.it can be erected for that purpofe.

  •*• If it were made the intereft of the poor to keep their children alive,
we fhould loofe very lew of them. AjYnall premium given annually to
each poor family, for every child taey have  alive at the year's end,
would fave more infant lives, than if t!vj whuic revenue of the crown
were expended in hofpitals for this purpofe.  This would make the poor
cileem fertility a blefling ; whereas many of them think it the greateft
curfe that caw bvfal i.h..-:n; and in pWce of wifhing their children to live,
(b far does poverty get the better of natural aife&ion, t:::.t :hey are often
very happy when thty die. 
38                  OF  CHILDREN.
  Whoever confiders the ftructure of the human body, will foon
be convinced of the neceffity of exercife for the health of children.
The body is compofed of an infinite number of tubes, whofe fluids
cannot be pufhed on without  the action and preffure of the muf-
cles. But if the fluids remain inactive, obftrudtions muft happen,
which cannot fail to occafion difeafes. Nature  has furnifhed both
the veffels which carry the blood and lymph with numerous valves,
in order that the action of every mufcle might pufh forward their
contents ; but without action,  this admirable contrivance can have
no effect. This part of the animal  ceconomy proves to a demon-
ftration the neceffity of exercife for the prefervation  of health.
  Arguments to fhow the  importance of exercife, might be drawn
from every part of the animal ceconomy : Without exercife,  the  ,
circulation  of the blood cannot be properly carried on, nor the dif-
ferent fecretions duly performed ; without exercife, the fluids can-
not be  properly prepared, nor the folids rendered ftrong or firm.
The action of the heart, the motion of the lungs,  and all the vital
functions,  are greatly affifted by- exercife. But to point out the
manner in which thefe effects are produced, would lead us farther
into the ceconomy of the human body, than moft of thofe for whom
this treatife is intended would be able to follow.  We fhall there-
fore only add, that, where exercife is neglected, none  of the ani-
mal functions can be duly performed ; and when that  is the cafe,
the whole conftitution muft go to wreck.
  A good conftitution ought certainly to be our firft object in  the
management of children. It lays a foundation for their being ufe-*
ful  and happy in life ; and whoever neglects it, not only fails in
his duty to his offspring, but to fociety.
  Qne very common error of parents, by which they hurt the con-
ftitutions of their children, is the fending them too young to fchool.
This is often done  folelyto prevent trouble. When the child is at
fchool, he needs no keeper. Thus,  the fchool-mafter'is made  the
nurfe; and the poor child is fixed to a feat feven or eight hours a
day, which time ought to be fpent in  exercife and  diverfions. Sit-
ting fo long cannot fail to produce the worft effects upon the body;
nor is the mind lefs injured. Early  application weakens the facul-
ties, and often fixes in the mind an averfion to  books, which con-
tinues for life*.
  But, fuppofe this were the way to make  children fcholars, it cer-
tainly ought not to be done'at the  expenfe of their conftitutions.
Our anceftors,  who feldom went to fchool very young, were  not
lefs learned than we. But we imagine the boy's education will be

  ■¥■  It is undoubtedly the duty of parents to inftrua their children, at
leaft, till they are of an age proper to take care of themfelves. This
would tend  much to  confirm  the ties of parental tendernefs and fiiid af-
fection, of the want of which, there are  at prefent fo many deplorable
inftances. Though few fathers have time to inftruft their children  yet
moft mothers have;  aadfurely, they cannot be better employed. ' 
OF  CHILDREN.                  39
quite marred, unlefs he be carried to fchool in the nurfe'* arms.  No
wonder if fuch hot-bed plants feldom become either fcholars or men.
  Not only the confinement of children in public fchools, but their
number, often proves hurtful. Children are much injured by be-
ing kept'in crowds within doors; their breathing not only renders
the place unwholefome, but if any one of them happens to be dif-
eafed, the reft catch the infection.  A fingle child has been often
known to  communicate the bloody-flu*, the hooping-cough, the
itch, or other difeafes, to almoft  every individual in a numerous
fchool.
 - But, if  infants are to be fent to fchool, teachers, as they value
the interefts of fociety, ought not to confine them too  long at a
time, but  allow them to run about and  play at fuch active diver-
fions  as may promote their growth, and ftrengthen their confti-
tutions. Were boys,inftead of being whipped for ftealing an hour,
to run, ride, fwim,  or the like,  encouraged to employ a proper
part of their time in thefe manly and  ufeful exercifes, it would
have many excellent effects.
   Ari effeminate education will infallibly fpoil the beft natural
conftitution ;  and if boys  are brought up in a more delicate man-
ner than even  girls ought to be, they never will be men.
   Nor is  the common education of girls lefs hurtful to the con-
ftitution than  that of boys. Mifs is fet down to her frame before
fhe can put on her  clothes ; and is taught to believe, that to ex-
cel "at the needle is  the only thing that can entitle her to general
efteem.  It is  unneceffary here to infill upon the dangerous con-
fequences of obliging girls to fit too  much. They are pretty well
known, and are too often felt at a certain time of life. But fup-
pofe this critical period be got over, greater dangers ftill await them
when they ccjme to be mothers. Women who have been early ac-
cuftomed to a  fedentary life, generally run great hazard in child-
bed ; while thofe who have been ufed to romp about, and take fuf-
 ficient exercife, are feldom in any danger.
   One hardly meets with a girl who can at the fame time boafl:
of early performances by the needle, and a good conftitution. Clofe
 and early confinement generally  occafions indigeftions, head-achs,
 pale-complexions, pain of the ftomach, lofs of  appetite, coughs.,
confumptiohs of the lungs, and deformity of the  body.  Thelaltof
thefe indeed is not to be wondered at,confidering the awkward pof-
 tures in which girls fit at many kinds of needle-woik, and the de-
licate flexible  ftate of their bodies in the early periods of life.
   Would mothers, inftead of having their daughters inftrudted in
 many trifling  accomplifhments,  employ them in plain work and
 houfewifery,  and allow them fufficient exercife in the open air,
 thev would both make them more healthy mothers, and more ufe-
 ful'members  of fociety.  1 am no enemy to genteel accomplifh-
 ments, but would have them  only confidered as fecondary, and al-
 wir. 8 difrcgarded, when they impair health. 
4o                 OF  CHILDREN.

   Many people imagine it a  great advantage for children to be
early taught to earn their bread. This opinion is certainly  right,
provided they were fo employed as not to hurt their health or
growth; but, when thefe fuffer, fociety, inftead of being benefitted,
is a real lofer by their labour. There are few employments, except
fedentary ones, by  which children can earn a livelihood ;  and if
they be fet to thefe too foon, it ruins their conftitutions. Thus, by
gaining a few  years frpm childhood,  we generally lofe twice as
many in the latter  period of life, and even render the perfon lefs
ufeful while he does live.
  In order to be fatisfied of the truth of this obfervation, we need
only look into the gr.eat manufacturing towns, where we fhall find
a puny degenerate  race of people, weak and  fickly all their lives,
feldom exceeding the  middle  period of life ; or  if they do, being
unfit for bufinefs, they become a burden to fociety. Thus, arts and
manufactures, though they  may increafe the riches of a country,
are by no means favourable to the health of its inhabitants.  Good
policy would therefore require, that fuch people  as labour during
life, fhould not be fet too early to work.  Every perfon converfant
in the breed of horfes, or other working animals, knows, that if
they be fet to hard  labour too  foon, they will never turn out to ad-
vantage. This is equally true, with refpect to the human fpecies.
  There are neverthelefs, various ways of employing young people
without hurting their health.  The eafier parts of gardening, huf-
bandry, or any bufinefs carried on without doors, arc moft proper.
Thefe are employments which moft v oung people are fond of, and
fome parts of them may always be adapted to their age, tafte, and
ftrength*.
   Such parents as  are under the necefiity of employing their chil-
dren within doors, ought to allow them fufficient time for active di-
verfions without.   This would both encourage them to do more
work, and prevent  their conftitutions from being hurt.
   Some imagine, that exercife within doors  is fufficient;  butthev
arc greatly miftaken.   One hour fpent in running, or any other
exercife without doors, is worth ten within.  When children can-
not go abroad, they may indeed  b^  e^rcifed at  home.  The beft
method of doing this, L; to  make them run  about in a long room,
or dance. This laft kind of exercife, if not carried to excefs is of
excellent fervice to young people.  It cheers the fpirits, promotes
perfpiration, flrengthens the limbs, 2;c.  I knew an eminent phyfi-
cian, who ufed to fay, that he made his children dance, inftead of
giving them phyfic. It were well if more people followed his ex-
ample.
   The cold-bath may be conudzred as an aid to exercife.  By it
the body is braced and ftrengthened, the circulation and fe'eretions

   * I have been told that in China, where th? police is the beft mi the
world, all the children are employed in the eafier part of gardening; ?r.d
hufbandry; as weeding, -athsrhig  ftune3 o:F -.he land, and fuch liie"' 
                    OF  CHILDREN.                 4j

promoted, and, were it conducted with prudence, many difeafes,
as the rickets, fcrpphula,  &c. might thereby be prevented.  The
ancients, who took every method to render children hardy and ro-
buft, were no ftrangers to the ufe of the cold bath ; and, if v/c may
credit report, the practice of immerfing chikiren daily in cold wa-
ter  muft have been very common among our ancefton.
  The greateft objection to the ufe of the cold bath arifes from the
fuperftitious prejudices of nurfes.  Thefe are often fo ftrong, that
it is impoffible to bring them to make a proper ufe of it.   I have
known fome of them who would not dry a child's fkin after bathing
it, left it fhould deftroy the effect of  the water.  Others will even
put cloths dipt in the water upon the child, and either put it to bed,
or fuffer it to go about in  that condition.
  , Every child when in health, fhould  at leaft have  its extremi-
ties "daily wafhed in cold water. This is a partial  ufe of the cold-
bath,  and is better than none. In winter this may fiiffice;  but in
the warm feafon, if a child be relaxed, or feem to have a tendency
to the rickets or fchrophula, its whole body ought to bs frequently
immerfed in cold water. Care however  muft be taken not to do
this when the body is  hot, or the ftomach full.  The child  fhould
be dipped only .once at a time, fhould be taken out immediately,
and have its fkin well rubbed with a dry cloth.
       The Effecls of unwholefonie Air upon Children.

  FEW things prove more deftructive to children, than confined
or unwholefome air. This is one reafon why fo few of thofe infants*.
who are put into hofpitals,or parifh work-houfes,live. Thefe places
are generally crowded with old, fickly and infirm people; by which
means the air is rendered fo extremely pernicious, that it becomes;
a poifon to infants.
  Want of wholefome air is likewife deftructive to many of the
Children born in great towns.  There the poorer fort of inhabitants
live in low, dirty, confined houfes, to which the frefh air has hardly
any accefs. Though grown people, who are hardy and robuft, may
live in fuch fituations, yet they generally prove fatal to their off-*
fpring, few of whom arrive at  maturity, and thofe who do, are
weak  and deformed.  As fuch people are not in a condition to carry
their children abroad in the open air, we muft lay  our account with
Iofing the  greater part of them. But the rich have not  thhvtxcufe,
It is their bufinefs to fee that their children be daily carried abroad,
and that  they be kept in the open air for a fufficient  time.  This
will always fucceed better if the mother goes along with them.
Servants  are often negligent in thefe matters, and allow a child to
fit or  fie on the damp ground, inftead of leading or  carrying it
about. The mother furely needs air as well as her children ;  and
how can fhe be better employed than, in attending them ? 
       41                  OF  CHILDREN."    -

         A very bad cuftom prevails,  of making children fieep  in final!
       apartments, or crowding two or three beds into one chamber.  In-
       ftead of this, the nurfery ought always  to be the largeft and beft
       aired  room in the houfe.  When ehildren  are confined  in fmalt
       apartments, the air not only becomes  unwholefome, but the heat
       relaxes their folids,  renders them delicate,  and  difpofes  them to
       colds  and  many other diforders. Nor is the cuftom of wrapping
       them up too clofe in cradles, lefs pernicious. One would think that
       nurfes were afraid left children fhould fuffer by breathing  free air,
       as many of them actually cover the child's face while afleep, and
       others wrap  a covering over the whole  cradle, by which mearis,'
       the  child is forced to breathe the fame  air over  and over, all the
       time it fleeps. Cradles indeed  are on many accounts hurtful tq,
       children, and it would be better if the  ufe of them were totally laid
       jfidef.
         A child is generally laid to fleep with all its clothes on ;  and if a
       number of others are heaped above them, it muft be overheated";
       by which means it cannot fail to catch cold on being taken out of
       the cradle, and expofed to the open air, with only its ufual clothing,  j
       which is too frequently the cafe.                                 1
         Children who are kept within doors all day, and fleep all night
'      in warm clofe apartments, may, with  great propriety,  be compar-,  j
       ed to plants, nurfed in a hot-houfe, inftead of the open air. Though
       fuch plants may, by  this means, be kept alive for fome time, they  ,
       will  never arrive at that degree of ftrength, vigour and  magnitude,
       which they would have acquired in the open air, nor  would they
       be able to bear it afterwards, fhould they be expofed to it.
         Children, brought up in the country,who have been  accuftomed
       to open air, fhould not be too early fent to great towns, where it is
       confined and unwholefome. This is frequently done with a view
       to forward their education, but proves very hurtful to their health.
       All  fchools and feminaries of learning ought, if  poffible,  to be fo
       fituated as to have frefh, dry, wholefome air, and fhould never be
       too much crowded.
         Without entering  into a detail of the particular advantages of
       wholefome air to children,  or of the bad confequences  which pro-
       ceed from the want of it, I fhall only obferve, that, of feveral thou-
       fands of children that have been under my care, I do not  remem-
       ber one inftance of a  fingle  child, who continued healthy in a clofe
       confined fituation; but have often known  the moft obftinate difeafes -t
       cured by iemoving them from  fuch a  fituation to an open  free air.

        t It is amazing how children efcape fuffocaticn, confidering the man- [
       ner in which they are often rolled  up in flannels, &c.  I lately attended
       an infant, whom I found muffled up over  head and ears in many folds of
       flannel, though it was  in the middle of June. I begged for  a little free
       air to the poor babe ; but though this indulgence was granted during my
       ftay, I found it always on my return in the fame fituation.  Death foon .
       freed the infant from all its miferies ; but  it was not in my power to free
       the minds of its parents from thofe prejudices which proved fatal to thei*
  ____:*MkL_________________________________________________: 
OF  CHILDREN,
43
                         Of Nurfes.

   IT is not here intended to lay down rules for the choice of nurfes.
 This would be wafting time. Common fenfe will direct everyone
 to chcofe a woman who is healthy, and has plenty of milk*. If fhe
 be at the  fame time cleanly, careful,  and good-natured, fhe can
 hardly fail to make a proper nurfef.  After all, however, the only
 certain proof of a good nurfe, is a healthy child  upon her breaft.
 But, as the mifconduct of nurfes often proves fatal to children, it
 will be of importance to point  out a few of their moft baneful er-
 rors, in order to roufe the attention of parents, and to make them
 look more ftridtly into the conduct of thofe to whom they commit
 the  care of their infant offspring.
   Though it admits of fome exceptions, yet, we may lay it down
 as a general rule, that every woman who nurfes for hire ought to
 be carefully looked after, otherwife fhe will not do her  duty. For
 this reafon> parents ought always to have their children nurfed un-
 der  their own eye, if poffible; and where this cannot be done, they
 fhould be extremely circumfpect in the choice of thofe perfons to
 whom they intruft them.  It is folly to imagine  that any woman,
 who abandons her own child to fuckle another for the fake of gain,
 fhould feel all the affections of a parent towards her nurfjing ;  yet
 foneceffary are thefe affections in a nurfe, that,,but for them, the
 human race would be extinct.
   One of the moft common faults of thofe who nurfe for hire, is
 to dofe children  with  flupefactives,  or fuch things as  lull  them
 afleep.  An indolent nurfe, who does not give a child fufficient ex-
 ercife in the open air to make it fleep, and does not choofe to be
 difturbed by it in the night, will feldom fail to procure for it a dofe
 of laudanum, diacodium, faffron, or,  what anfwers the fame pur-
 pofe, a dram of fpirits, or other ftrong liquors, Thefe, though they
 be certain  poifon to infants, are every day adminiftered  by many
 who bear the character of very  good nurfesj.
  A nurfe who has not milk enough, is apt to imagine that this de-
 fect  may be fupplied by giving the child wines, cordial-waters, or
 other ftrong Jiqiiors. This is an egregious miftake.  The only thing
 that  has any chance to fupply the place of the nurse's milk, muft
 be fomewhat nearly  of the fame quality, as cow's  milk, afs's milk,

  ■*•  I have often known people fo impofed upon, as to give an infant to
 a nurfe to be fuckled who had not one drop of milk in her breaft.
  t In addition to thefe cmalifications, fhe fhouid be clear of any defor-
 mity about her eyes, fuch as fquintiDg, &c. as children are Very liable to
contract unpleafant habits from their nurfes.  (I. C.)
  |  If a mother on vifiting her child at nurfe finds it always afleep, I
would advife her to remove it immediately j otherviit, it will foon fleep
its laft. 
44                 OF CHILDREN.
or the like, with good bread. It never can be done by the help of
ftrong liquors. Thefe, inftead of nourifhing an infant, never fail to
produce the contrary effect.
   Children are often hurt by nurfes fuffering them to cry long and
vehemently. This ftrains their tender bodies, and  frequently oc-
cafions ruptures, inflammations of the throat, lungs, &c A child
never continues to cry long without fome caufe, which might  al-
ways  be  difcovered  by proper attention ; and the nurfe who can
hear an infant cry till it has almoft fpent itfelf, without endeavour-
ing to pleafe it, muft be  cruel indeed, and is unworthy to be in-
trufted with the care of an human creature.
   Nurfes who deal much in medicine are always to be fufpected.
They truft to it, and neglect  their duty.  I never knew a good nurfe
who had her Godfrey's cordials, Daffy's elixirs, &c at hand. Such
generally imagine, that a dofe of medicine will make-up for all de-
fects  in food, air, exercife and cleanlinefs.
   Allowing children to continue long wet, is another  very perni-
cious cuftom of indolent nurfes. This is not only difagreeable, but
it galls and frets the infant, and fiy relaxing the folids, occafions
fchrophuhs, rickets, and other difeafes.  A dirty nurfe is always to
be fufpected.
   Nature often attempts to  free the  bodies of children from bad
humours, by throwing  them upon the fkin : By this means fevers
and other difeafes are prevented.  Nurfes are  apt to miftake  fuch
critical eruptions for an  itch, or  fome other infectious diforder.
Accordinglv, they take every method to drive them in.  In this way
xiany children lofe their lives ; as nature is  oppofed  in the very
i.rethod that fhe takes to  relieve them.  A nurfe fhould never flop ■
»ny eruption without proper advice, or being well  affured that it
33 net of a critical nature. At any rate, it is never to be done with-
cut previous evacuations.
   Lcofe  flools are another method by which nature often prevents
<-.r carries off the difeafes of infants. If thefe proceed too f?r, they
ought to be checked ;* but  never  without great  caution. Nurfes,
•upon the firft appearance of loofe ftools, frequently fly to the ufe of
aftringents, or fuch things as bind the body. Hence inflammatory
fevers, and other fatal difeafes, are occafioned. A dofe of rhubarb, '
a gentle vomit, or fome other evacuation, fhould always precede the
life of aftringent medicines*.
   One great fault of nurfes  is, concealing the difeafes of children
frcm their parents. This they are extremely ready to do, efpecialty
when the difeafe is the effect ci their own negligence.  Many in-


   ■* Some nurfes are fo extremely nice, that rather than take the trou- !
ble of clcanfing a child frequently, they will attempt to  flop up the naf- S
fage : Squeamifh maids have actually ufed cork-; for this purpofe. What
have not  mothers to fear, who in truft their children to the care of fuch
tvorthlefs drabs ?                            - 
OF  CHILDREN.
45
Frances might be given of perfons  who  have been rendered lame
for life  by a fall from their nurfe's arms, which file  through fear,
concealed till the misfortune was paft cure.  Every parent who in-
trufts a nurfe with the care of a child, ought to give her the ftrictelt
charge not to conceal the moft trifling diforder or misfortune that
may befal it.
   We can fee no reafon,  why  a  nurfe, who conceals  any  mif-
fortune which happens to a child under her care, till it lofes its life
erlimbs,fhouldnotbe punifhecl.  Afew examples of this kind would
fave the lives of  many infants ;  but as there is little reafon to ex-
pect that it will ever be the cafe, we would earneftly recommend
it to all  parents to look  carefully after their children, and not to
truft fo  valuable a treafure entirely in  the hands of an hireling.
   No perfon ought to imagine thefe things unworthy of his atten-
tion. On the proper management of children depend  not only their
health and ufefulnefs in  life, but likewife the fafety and prosperity  .
of the flate to which they belong.  Effeminacy ever will prove the
ruin of any ftate  where it prevails ;  and, when its foundations arc
laid in infancy, it can never arterwards  be wholly eradicated. Pa-
rents who love their offspring, and wifh well to their country,will,
in the management of their children, avoid every  thing that tends
to make them weak or effeminate, and take eyery  method in their
power to render their conftitutions ftrong and hardy.
                  -----By arts like thefe
   Laconia nurs'd of  old her hardy fons;
   And  Rome's unconquer'd legions urg'd their way,     ;
   Unhurr, thro' every toil in every clime.            Armftrong.
                 CHAPTER  II.

     Of the Laborious, the Sedentary', and the Studious,

      MEN are expofed to particular difeafes from the occupations
       which they follow; but to remedy this evii is difficult. Moft
people are under the neceffity of following thofe employments to
which they have been bred, whether they be favourable  to health
or not. Inftead of inveighing, as fome authors have done, againft
thofe occupations which are hurtful to health, we fhall endeavour
to point out the circumftances  in each of them from which the
danger chiefly arifes, and to propofe the moft rational methods
of preventing it.
   Chemifts, founders, forgers, glafs-makers, and feveral other ar-
tifts, are hurt by the unwholefome air which they are obliged  to
breathe.  This air is not only loaded with the  noxious exhalations 
46..   OF THE LABORIOUS, THE SEDENTART,

arifing from  metals and minerals, but is fo charged with phlogifton
as to be rendered unfit for expanding the lungs fufficiently, and
anfwering the other important purnofes of refpiration. Hence pro-
ceed afthmas, coughs, and confumptions of the lungs, fo incident
to perfons who follow thefe. employments.
   To pr.vent fuch confequences, as far as poffible, the places where
thefe occupations  are carried on, ought  to be conftructed in fuch
a  manner as to difcharge  the fmoke and other  exhalations, and
admit a free current of frefh air. Such artifts ought never  to con-
tinue  too  long at work; and when they give  over, they fliould
fuffer themfelves to cool gradually, and put on their clothes before
they go into  the open air. They ought never to drink large quanti-
ties of cold,  weak, or watery liquors, while their bodies are hot,
nor to indulge in  raw fruits, fallads, or any thing that is cold on
the ftomach.
   Miners, and all who work under  ground,  are likewife hurt by
unwholefome air.  The air, by its ftagnation in deep mines, not
only lofes its proper fpring and  other qualities neceffary for refpi-
ration, but is often loaded with fuch noxious exhalations as to be-
come a moil deadly poifon.
   The two kinds  of air which prove moft deftructive to miners,
are what they call the fire damp,  and the choke damp. In both
cafes the air becomes a poifon, by its being loaded with phlogifton.
   The danger from the former  may be obviated by making it ex-
plode before it accumulates in too great quantities; and the latter
maybe generally carried off by promoting a free circulation of air
in the mine.
   Miners  are not  only hurt by unwholefome air, but likewife by
the particles of metal which adhere to their fkin, clothes, &c. Thefe
are abforbed, or taken  up into the body, and occafion palfies, vef-
tigoes, and other nervous affections, which often prove fatal.  Fal-
lopius obferves, that thofe who work in  mines of mercury,  feldom
live above three or four years. Lead, and feveral other metals, are
likewife very pernicious to the health.
   Miners  ought never to go to work fafting, nor to continue too
long at work. Their food ought to be nourifhing, and their liquor
generous:  Nothing more certainly  hurts them than living too low.
They fhould by all means avoid coftivenefs.  This may either be
done by chewing a little rhubarb, or taking a fufficient quantity of
iallad oil.  Oil .not only opens the  body, but fheaths and defends
the inteftines from the ill effects of the metals.  All who work in
mines or metals ought to wafh. carefully, and to change their  clothes
as foon as they give over working.  Nothing would tend more to
prefcrve the  health of fuch people than a ftrict regard to cleanlinefs.
   Plumbers, painters, gilders, fmelters,  makers of white-lead and
many others who work in metals, are liable to the fame difeafes as
miners, and ought to obferve the fame directions for avoiding them.
   Tallow-chandlers, boilers of oil, and all who work in putrid ani- 
                AND THE STUDIOUS.               47

 mat fubftances, are likewife liable to fuffer from the unwholefome
 fmells or effluvia of thefe bodies. They ou^ht to pay the fame re-
 gard to cleanlinefs as  miners; and when they are affected with
 naufea, ficknefs, or indigeftion, we would adyife them  to take a
 vomit or a gentle purge. Such fubftances ought always to be ma-
 nufactured as foon as poffible. When long kept, they not only be-
 come unwholefome to thofe who manufacture them, but likewife
'to people who live in  the neighbourhood.
    It would greatly exceed the limits of this part of our fubject, to
 fpecify the difeafes peculiar to perfons of every occupation ;  we
 fhall therefore confider mankind under the general claffes of Labo-
 rious, Sedentary, and Studious.                               ,
                       The Laborious.

   THOUGH thofe who follow laborious employments are in ge-
 neral the moft healthy of mankind, yet the nature of their occupa-
 tions, and the places where they are carried on, expofe them more
 particularly to fome difeafes. Hufbandmen,  for example, are ex-
 pofed to all the viciffitudes of the weather, which in America, are
 often very great and fudden, and occafion colds, coughs, quinfies,
 rheumatifms, fevers, and other acute diforders. They work hard,
 and often carry burden above their 'ftrength, which, by overftrain-:
 ing the veffels, occafion afthmas, ruptures, pleurifies, &c.
   Thofe who labour without doors areaften afflicted with inter-
 mitting fevers or agues, occafioned  by the  frequent viciffitudes o£
 heat and cold, poor living, bad water, fitting or lying on the damp
 ground, evening dews, night air, &c. to which they are frequently
 expofed.
   Such as bear heavy burdens, as porters^labourers, Sec. are obli-
 ged to draw in the  air with much greater  force, and alfo  to keep
 their  lungs diftended with more violence than is neceffary for com-r
 mon refpiration :  By this means the tender veffels of the lungs are
 over-ftretched, and  often burft, infomuch that a fpitting of blood
 or fever enfues. Hippocrates mentions an inftancef of a man, who,.
 upen  a wager^ carried an afs ; but was  foon  after feized  with a,
 fever, a vomiting of blood, and a rupture.
   Carrying heavy burdens is generally the  effect of mere lazinefs*
 which prompts people to do at once what fliould be done at twice.
 Sometimes  it proceeds from vanity or emulation. Hence it  is, that
 the ftrongeft men are moft commonly hurt by heavy burdens, hard
labour, or feats of activity. It is rare to find one who boafta of his
 flrength, without a rupture, a fpitting of blood, or fome other dif-
eafe, which he reaps as the fruit of his folly.  One would imagine
the daily inftances we have of the fatal effe&s of carrying great 
48  OF THE LAEORIOUS, THE SEDENTARY,

weights,  running,  wreftling, and the like, would/be luflicient <0
prevent fuc*h practices.
   There are indeed fome employments which neceffarily require a
great exertion of ftrength, as porters, blackimiths, carpenters, &c.
None ought to follow  thefe but men of ftrong body ; <;nd they
fl-.ould  never exert their ftrength to the utmoft, nor work too long.
When  the mufcles  are violently ftrained, frequent reft is neceffa-
ry, in order  that they may recover their tone;  without th.s, the
ftrength and conftitution will foon be worn out, and a premature
old age be induced.
   The erifipelas, or St. Anthony's fire, is  a difeafe very incident
to the  laborious.  It  is occafioned by whatever gives a fudden
check to  the perfpiration, as drinking cold water when the body
is warm, wet feet,  keeping on wet clothes, fitting or lying on the
dr.mp ground, &c.  It is  impcffible for thofe who labour without
doors  always  to guard againft  thefe inconveniencies ; but it is
known from experience, that their ill confequences  might often
be prevented by proper care.
   The iliac prffion, the cholic, and other complaints of the bowels,
are often occafioned by the fame caufes as the erifipelas ; but they
may likewife proceed  from  flatulent and  indigeftible  fcod.  La-
bourers generally eat unfermented bread, and  great  quantities of
unripe fruits, baked,  ftewed, or raw, with various kinds of roots
and  herbs, upon   which they often drink four milk, ftale fmall
beer, or the like.   Such a mixture cannot fail to fill the bowels
with wind, and occafion difeafes of thofe parts.
   Inflammations, whitloes?.and other difeafes of the extremities, are
likewife common  among thofe who labour without doors.  Thefe
difeafes are often  attributed to venom,  or  fome kind cf poifon;
but they generally  proceed either from fudden  heat after cold, or
the contrary.  When labourers, milk-maids, &c. come from the
field, cold or wet, they run to the fire, and often plunge their hands
in warm  water, by which means the blood and other humours in
thofe parts, are fuddenly expanded, and, the veffels not yielding
fo quickly, a ftrangulation happens, and an  inflammation or morti-
fication enfues.
   When fuch perfons come home  cold, they ought  to keep at a
diftance  from the  fire for fome  time, to wafh their hands in cold
water, and to rub them well with a dry cloth.   It  fometimes hap-
pens, that people are fo benumbed with cold,  as to be quite de-
prived of the ufe of their limbs.  In this cafe, the only remedy is
to rub the parts affected with fnow, or, where it  cannot be had,
with cold water.   If they be held near the fire, or plunged  into
warm  water,'a mortification will generally enfue.
   Labourers in the hot feafon are apt to lie down  and fleep in the
fun. This practice is fo dangerous, that they often wake in a burn-
ing fever.  Thefe  ardent fevers, which prove fo fatal about the end
 of fummer and beginning of autumn, are frequently occafiond bf 
                 AND THE STUDIOUS.           '  49

 this means. When labourers leave off work, which they ought al-
 ways to do during the heat of the day, they fhould go home, or, at
 leaft, get under fome cover, where they may repofe themfelves in
 fafety.  ■
   Many people follow their employments in the fields frcm morn-
 ing till night, without eating any thing.  This cannot fail to hurt
 their health.  However homely their fare be, they ought to have
 it at regular times ; and the harder they work, the more frequently
 they fhould eat.  If the  humours be not  frequently  replenifhed
 with frefh nourifhment, they foon become putrid, and produce fe-
"Ters of the very worft  kind.
   Many peafants are extremely carelefs with refpect to what they
 eat or drink, and often, through mere indolence, ufe unwholefome
 food, when they might for the fame  expenfe have that which is
 wholefome.  In fome  parts of Britain, the peafants are too carelefs
 even to take the trouble of dreffing their own victuals.  Such peo-
 ple would live upon one meal a-day in indolence, rather than la-
 bour, though it were to procure them the greateft affluence.
   Fevers of a very bad kind are often occafioned among labourers
 by poor living.  When the body is not fufficiently nourifhed, the
» folids become weak;  from whence the moft fatal confequences
 enfue.  Poor fwing is likewife productive of many of thofe cuta-
 neous difeafes fo frequent among the lower clafs of people. It is
 remarkable that cattle, when pinched in their food, are generally
 affected with difeafes  of the flcin, which feldom fail to difappear,
 when they are put upon a good pafture.  This fhows how much a
 good ftate of the humours depends upon a fufficient quantity of pro-
 per nourifhment.
   Poverty not only occafions, but aggravates, many of the difeafes
 of the laborious.  Few of them have much forefight; and, if they
 had, it is feldom in their power to fave any thing. They are glad to
 make a fhift to live from day to day; and, when any difeafe over-
 takes them, they are miferable indeed. Here, the godlike virtue of
 charity ought always  to exert itfelf.  To relieve the induftrious
 poor in diftrefs, is furely the moft exalted act of religion and  hu-
 manity.  They alone, who are witneffes of thofe feenes of calamity,
 can form an opinion of what numbers perifh in difeafes, for wanti
 of proper affifbmce, and even for want of the neceffaiies cf life.
   Labourers are often hurt by an emulation, which prompts them
 to vie with one another, till they overheat themfelves to fuch a de-
 gree as to occafion  a fever, or even to drop down dead.  Such ag
 wantonly throw away their lives  in this manner, <bfe*ve  to be
 looked upon as felf-murderers.                           ^-r
   Soldiers fuffer many hardfhir.s from the inclemency  of feafons,
 long marches, bad provifions, hunger, watching, unwholefome cli-
 mates, bad water, &c. Thefe occafion fevers, fluxes, rheuma'tifms,
 and other fatal difeafes, which generally do greater execution than
 the fword, especially  when campaigns  areT-ontinued  too late in.
                             g       y 
 5^   OF THE LABORIOUS, THE SEDENTARY,

 the fer.fon. A few  weeks of cold  rainy weather will often prove ,
^ore fatal than an engagement.
   Thofe who have the command  of  armies fliould take care that
 their foldiers be well clothed and^wcll fed. They ought alfo to i:-
 nifh their campaigns  in due feafon, mid to provide  their men with
 dry and well-aired winter quarters.  Thefe rules, taking care, at the
 feme time, to keep the fick at a proper diftance from  thofe in health,
 would tend greatly to preferve the lives of the foldiery.
   Sailors may be numbered among the laborious.  They  undergo
 great hardfhips from change of climate, the violence of weather,
 hard labour,  bad proviiioiii, Sec.   Sailors are of  fo great impor-
 tance to the trade  of  a nation, that too much pains can never be
 bellowed in pointing out the means of preferving their lives.
   One great fource of the  difeafes of lea-faring people is e.vcefs.
 When they get on  fhore, after having been long at  fea, without re-
 gard to the climate, or their o\wi conftitutions,  they plunge head- -
 feng into all manner of riot, and ofe-n jperfift till a fever puts an
 end  to their lives. Thus, intemperance,and not the climate, is often
 the caufe whyfo many of our failors die on foreign coafts.  i-uch   j
 people ought not tolive too  low ; bvtthey will find  moderation the
 beft  defence againft fevers, and many  other maladies.
   Sailors, when on duty, cannot  avoid fometimes getting wet.
 When this happens, they  fhould  change their clothes as foon as
 they are relieved,  and take every method to reftore the perfpira-
 tion. They fhould not in this cafe, make too free with fpirits or
 other ftrong liquors, but fliould rather  drink them diluted with
 warm water, and go immediately  to bed, where a  found fleep and
 a gentle fweat would fet all to rights.
   But the health of  failors fuffers moft  from unwholefome food.
 The conftant ufe of felted  provisions, with a fcant allowance of
 bad, water debilitate their conftitutions, occafions the feurvy, and   ■
 other obftinate maladies. It is no eafy matter to prevent this dif-
 eafe in long voyages; yet much might  be done towards  effecting
 fo defirablean' end, were due pains bellowed for that purpofe. For
 example, various roots, greens, and  fruits, might be kept a long
 time at  fea, as onions, potatoes, cabbages, lemons, oranges, tama-   /
 rinds, apples, &c.  When fruits cannot be kept, the juice of them,
 either frefh  cr fermented, may.  With thefe,  all the  drink, and
 even the food of the Ihip's company, ought to be acidulated  in
 long voyages.
   Stale-bread and beer likewife contribute to vitiate the humours.
 Flour will keep for a long time  on board, of which  frefh bread
 might frequently be'made.   Malt, too, might be kept, and infufed
 with boiling water at any time. This liquor, when drank even in
 form of wort, is very wholefome, and is found to be  an antidote
 againft  the feurvy. Snuil wines and  cyder might likewife b^e plen-   *
 tifuily laid in ; and fhould they turn four, they  would ftill be ufe-
 ful  as vinegar.  Vinegar is a great antidote againft difeafes, and 
AND THE STUDIOUS.
51
fliould be ufed by all. travellers, efpecially at fea.  It may either
be mixed with the water they drink, or taken jn their food.
  Such animals as can be kept alive, ought to be carried on board,
as heno, ducks, pigs, Sec. Frefh broths made of portable foup, and
puddings made of peas, or other vegetables, ought to be ufed plen-
ih'uilv. Many other things will readily occur to people convevfent
in thefe makers,  which would tend to preferve the health of that
brave and ufeful fet of .men*.
  Wc have reafen to believe,  if due attention were paid to the
diet, air, clothing, and above all things,  to the cleanlinefs of fea-
faring people, they would be the molt healthy fet of men hi the
world ; out when thefe are neglected, the very reverfe will happen.
  The beft medical antidote that we can  recommend to failors or
folfliers on foreign coafts, efpecially where dampnefs prevails, is
the Peruvian bark. This will often prevent fevers  and other fatal
difeafes;  About a drachm of it may be chewed every day, or if this
fhould prove difagreeable, an ounce of bark, with half an ounce of
orange-peel,  and  two drachms of  fnake-root  coarfely powdered,
may be infufed two or three days in an  Englifh quart of brandy,
and half a wine-glafs of it taken twice or thrice a day, when the
ftomach,is empty. This has been found to be  an excellenf antidote
againft fluxes, intermitting, and other fevers, in unhealthy climates.
It is not material in what form this medicine is taken. It  may ei-
ther be infufed in water,  wine, or lpirits, as recommended above,
or made into an electuary with fyrup of lemons, oranges, or the like.
                      . The Sedentary.

  THOUGH nothing can be more contrary to the nature of mr.n
than a fedentary life, yet this clafs comprehends by far the greater
part of the fpecies.  Almoft the whole female world, and in manu-
facturing countries, the major part of the males, may be reckoned
fedentaryf.

  #■ Coptain Cook has fhpwn how far, by proper-care and attention, the
difeafes formerly fo fatal to feamen, may be prevented.  In a voyage of
three  years and eighteen days, during which he was expofed to every
climate, from the 520 north 10 the 710 offouth latitude, of one hundred
and eighteen men, compofing the fhip's company, he ioft only one, who
died or a phthifis pulmonaiis.  The principal means he ufed were, to
preferve aftrict attention to cleanlinefs, to procure abundance of vege-
tables and frefh provifions,  efpecially good water,,and to allow his peo-
ple  fufficient time for reft.
  + The appellation of fedentary has generally been given only to the
ftudious; we can fee no reafon, however, for reftrifting it to them alone.
Many artificers may, with-as much propriety,  be denominated fedentary
as the ftudious, with this particular disadvantage, that  they are often
obliged to- fit in very awkward \^ '..'■■ u:•■."-, which tvr lludious need noc t-n •
lefs they pleafe. 
 52  OF THE LABORIOUS, THE  SEDENTARY,

   Agriculture, the firft and moft healthful of all employments, ia
 how followed by few who are able to carry on any other bufinefs.
 But thofe who imagine that the culture of the earth is not fuffici-
 ent to employ nil its inhabitants, are greatly miftaken.  An ancient
 Roman, we are told, could maintain his family from the produce
 of one acre of ground. So  might a modern Briton, if he would be
 contented to live like a Roman. This fliows what an immenfe in-
 creafe of inhabitants Britain might admit  of, and all of them live
 by the culture of the ground.
   Agriculture is the great  fource of domeftic riches.  Where  it is
 neglected, whatever wealth may be imported from abroad, pover-
 ty and mifery will abound at home. Such is, and ever will be, the
 fluctuating ftate of trade and manufactures, that thoufands of peo-
 ple may be in full employment to-day, and in beggary to-morrow.
 This can never happen to  thofe who cultivate the ground.  They
 can  eat the fruit of their labour, and can always by induftry ob-
 tain, at leaft, the neceffaries of life.
   Though fedentary employments are neceffary, yet there feems
 to be no reafon  why any perfon fhould be  confined for life to thefe
 alone.   Were fuch employments  intermixed with the  more ac-
 tive  and laborious, they would never do hurt.  It is coriftant con-
 finement that ruins the health.  A man will not be hurt by fitting
 five or fix hours a-day; but if he is obliged to fit ten or twelve, he
 will  foon become  difeafed.
   But it is not  want of exercife alone which hurts fedentary peo-
 ple ; they likewife fuffer from the confined air which they breathe.
 It is very common to fee ten or a dozen taylors*, or ftaymakers,
 for example, crowded into one fmall apartment, where there is
 hardly room for one perfon to breathe freely.  In this fituation
 they generally continue for many hours at a time, often with the
 addition of fundry candles, which tend likewife to wafle the air
 and render it lefs fit for refpiration. Air that is breathed repeated-
 ly becomes unfit for expanding the lungs.  This is one caufe of
 the phthifical coughs, and  other complaints of the breaft, fo inci-
 dent to  fedentary artificers.
   Even the perfpiration from a great  number of perfons pent up
 together,renders the air unwholefome. The danger from this quar-
ter will  be greatly increafed, if any one of them  happens to have
 bad lungs, or to be  otherwife difeafed.  Thofe who fit near him  be-
 ing forced to breathe the fame air, can hardly fail to be infected.
It would be  a rare thing to find a dozen fedentary people all in

  *■  A perfon of  obfervation  in that line of life told me, that moft tav
 lors die of confuniptions ; which he attributed chiefly to the unfavoura
 ble pofturesin  which they fit, and the unwholefomenefs of thofe places
 where their bufinefs is carried on. if more  attention was not paid to
 prolit than to the prefervation of human lives, this evil might bee f I »
 remedied; but while mafters only mind their own  intereft  no thins
Will be done for  the fafety of their fervant*.                     s 
              AND THE STUDIOUS.              .jtf

good health.  The danger of crouding them together muft there-
fore be evident to every one.
   Many of thofe who follow fedentary employments are conftantly
in a bending potture, as fhoe-makers, taylors, cutlers, &c.  Such a
fituation is extremely hurtful.  A bending pofture obftructs all the
vital motions, and of courfe muft deftroy the health. Accordingly,
we find fuch artificers generally complaining of indigeflions, flatu-
lences, head-achs, pains of the breaft, &c.
   The aliment- in fedentary people, inftead of being pufhed for-
wards by an erect pofture, and the aftion of the mufcles, is in a
manner confined in the bowels.  Hence, indigeflions, coftivenefs,
wind,&other hypocondriachal affeaions, are thecompanions of the
fedentary. No excretion can be duly performed where exercife is
wanting ; and when the matter which  ought to be discharged in
 this way, is retained too long in the body, it muft have bad effects,
• 'as it is again taken up into the mafs of humours.
   A bending  pofture is hurtful to the lungs.  When this organ is
 compreffed, the air cannot have free accefs into  all its parts, fo aa
 to expand them properly. Hence tubercles, adhefions, &c.  are
 formed, which often end in confumptions. Befides, the proper ac-
 tion of the lungs being absolutely neceffary for making good blood,
 when that organ fails, the humours foon  become univerfally de-
 praved, and the whole conftitution goes to wreck.
    Sedentary artificers are not only hurt by preffure on the bowels,
 but alfo on the inferior extremities, which obftructs the circula-
 tion in thofe pans, and renders them weak and feeble.  Thus, tay-
 lors, fhoe-makers, &c frequently lofe the  ufe of their legs altoge-
 ther ; befides, the blood and humours are, by ftagnation, vitiated,
 and the perfpiration is obftructed: From whence proceed the fcab,
 ulcerous fores, foul blotches, and other cutaneous difeafes, fo com-
 mon  among fedentary artificers.
    A bad figure of body is a very common confequence of clofe ap-
 plication to fedentary employments. The fpine, for example, by
 being continually bent, puts on a crooked fhape, and generally re-
 mains fo ever after. But a bad figure of body has already been ob-
 ferved to be hurtful to health, as the  vital functions  are thereby
 impeded.
    A fedentary life feldom fails to occafion an univerfal relaxation
 of the folids.  This is the great fource from whence moft of the
 difeafes of fedentary people flow. The fchrophula, confumption,
 hyfterics, and nervous difeafes,  now fo common, were very little
 known in this country before fedentary artificers became fo nume-
 rous : And they are very little known ftilKamong fuchof our peo-
 ple as follow adive employments without doors, though in great
 towns, at leaft two thirds of the inhabitants are afflicted with them.
    It is very difficult to remedy thofe evils, becaufe many who have
 been accuftomed to a fedentary life, like ricketty children, lofe all
 inclination for exercife; we fhall throw out a few hints with refpect 
 54    OF THE LABORIOUS,THE SEDENTARY,

to the moft likely means for preferving the health cf chis ufeful fet ^
of people.
   Sedentary artificers are often  hurt by  their bending  pofture.   j
They ought to ftand or fit as erect as the na:ure of their  employ-
ments will permit. They  fliould  change their  pofture frequently,
and never fit too long at a time, but leave off work, and walk, ride,
run, or do any thing that will promote the vital functions.
   Sedentary artificers are generally allowed too littie time for ex-
ercife; yet, fhort as it is, they feldom employ it properly.  A jour-   ;
r.cyman taylor or weaver, for exampfe, inftead of walking abroad   <
for exercife and frefh air, at his hours of leifure, choofes  often  to
fpend them in a  pub'ic-hoafe, or in playing  at fome fedentary
gime, by which, he generally lofes both his time and his money.
   The awkward poftures in which many fedentary artificers work,
feem rather to be the eifea of cuftom than necefihy. Tor example,
a table mi~ht: furejy L.  e.mtrived  for ten or a dozen  taylors to  fit
round, with liberty for i- 'ir legs either to  hang down, or reft upon
a foot-board, as they ihou.d choofe. A place might be cut out for
each perfon, in fuch a manner that he might fit as conveniently for   '
working as in the prefent moc  of fitting crofs-legged.
   All fedentary artificers ou^ht i„ p? y the moft religious regard to
cleanlinefs. Both their fituation and occupation render this highly
neceffary.  Nothing would contribute more to preferve their health,
than a ftrict attention to it; and fuch of them as neglect it, not only
run the hazard of lofing health, but of becoming a nuifance to their
neighbours.
   Sedentary people ought to avoid food that is windy, or hard of
digeftion,  and pay the ftricteft regard to  fobriei.y.  A perfon who
works hard without doors will foon throw off a debauch ; but one
who fits has by no means an equal chance. Hence fedentary peo-   ;
pie are often feized with fevers after hard drinking. When fuch per-   '
fons feel their fpirits low, inftead  of running to the tavern for re-
lief, they fhould ride, or walk in the fields.  This would remove the
complaint more  effeaually than  ftrong liquor, raid would  never   •
hurt the cenftitution.                                        ./
   We fhall recommend the following general plan, viz. That ever
ry perfon who follows a fedentary employment fhould cultivate a
piece of ground with his own hands. This he might dig, plan*,
fow, and weed at leifure hours, fo as to make it both an  exercife   ^
and amufement, while it, produced many of the neceffaries of life.
After working an hour in a garden, a man will return with more
Iceennefs to his employment within doors, than if he had been  all
the while idle.
   Labouring the ground is every  way conducive to health.  It not
only'gives exercife to every part of the body, but the very fmell of
the earth and  frefh herbs  revives  and cheers the fpirits, whilft the
perpetual profpect of fomething coming to maturity, delights and
entertains the mind. We are always pleafed with fornewhat in pro£ 
AND THE STUDIOUS.
55
peft, however diftant or trivial. Hence the happinefs that moii
tiien feel in planting, fowing, building, Sec. Thefe feem to have
been the chief employ merits of the more-early ages :  And wheat
kings and conquerors cultivated the ground, there is reafon to be-
lieve, they knew as well wherein true, happinefs confifted as we.do.
   It may feem romantic to recommend gardening to manufaaurers
in great  towns; the plan is very praaicable.  In Sheffield, where
the great iron manufacture is carried on, there is hardly a journey-
man cutler who does not poffefs a piece of ground, which he cul-
tivates as a garden. This praaice has many falutary effeas. It not
only  induces thefe people to take exercife without doors, but ztfo
to eat many greens, roots, Sec. of their own growth, which  they
would never think of purchafii^g.  There can be no reafon  why ma-
nufaaurers in any other towns of Britain fliould not follow the
fame plan. In London, .a plan of this kind is not praaicable ; yet
even there, fedentary artificers may find opportunities of taking air
and exercife, if they  choofe to embrace their..
   ^Mechanics  are too mueh inclined  to crowd into great towns.
The  fituation may have  fome advantages; but it has many difacU
vantages. All  mechanics who live in the country have it in their
power to cultivate a piece of ground ; which, indeed, moft of them
do.  This not  only gives them  exercife, but enables them to live
more comfortably. So far at leaft as my obfervation extends, me-
chanics  who live in  the country -are far more happy than thofe in
great towns. They enjoy better health, live in greater affluence,
and feldom fail to rear a healthy and numerous offspring.
   In a word,  exercife without doors,  in one fhape or another, is
abfolutely necefLry to health. Thofe who negfea it, though they
may for  a while drag out life, can hardly be faid to enjoy it. Weak
and effeminate, they languifh for a few yeaiv, and foon drop into
an untimely grave.
i                        The Studious.
»

   INTENSE thinking is fo deftruaive to health, that few inftan-
ces can be produced of ftudious perfons who are ftrong and heal-
thy. Hard ftudy always implies a fedentary life ; and when intenfe
thinking is joined to  the want of exercife, the confequence muft
be bad. We have frequently known even a few months of clofe ap-
plication to ftudy, ruin an excellent conftitution, by inducing a
train of nervous complaints which could never be removed. Man
is evidently not formed for continual thought more Jtart for per-
petual aaion, and would be as foon worn out by the one as by the
other.
   So great is the power of the mind over the body, that, by its in-
fluence  the whole vital motions may be accelerated or retarded, 
 56   OF THE LABORIOUS, THE SEDENTARY,

 to almoft any degree. Thus cheerfulnefs and mirth quicken the cir-
 culation, and  promote all  the  fecretions;  fadnefs and profound
 thought retard them.  Hence, even a degree of thoughtleffnefs is
 neceffary to health.  The perpetual thinker feldom enjoys either
 health or fpirits; while the perfon who can hardly be faid to think
 at all, generally enjoys both.
   Perpetual thinkers, as they are called, feldom  think  long. In a
 few years they generally become quite flupid, and exhibit a melan-
 choly proof how readily the greateft bleffidgs may be abufed. Think-
 ing, like every thing elfe, when  carried to an extreme, becomes a
 vice : nor can any thing afford a greater proof of wifdom, than for
 a man frequently and feafonably to unbend  his mind.  This may
 generally be done by mixing in cheerful company, aaivediverfions,
or the like.
   Inftead of attempting to inveftigate the nature of that connexion
 which fubfifts between the mind and body, or to enquire into the .,
manner  in which they mutually affea each othec, we fhall only
 mention thofe difeafes to which the learned are  more peculiarly
 liable, and endeavour to point out the means  of avoiding them.
   Studious perfons are very fubjea to the gout.  This painful dif-
 eafe in a great mcafure proceeds  from ir:dfea:l' m, and rei obftruc-
ted perfpiration.  It is imprsfPMe  fha" the man who fit:; horn morn-
 ing till night fhoulH either digeft his food, or have any of the fe-
 cretions in due quantity.  i;ut  when that  matter,  which fhould be
 thrown  off  by the fkin, is retained in the body, and the humours
 are not duly  prepared, difeafes muft enfue.
   The ftudious are likewife very liable to the flone and gravel.  Ex-
 ercife greatly promotes both the fecretion and difeharge of urine;
 a fedentary life muft have the contrary effea.  Any one may be
fatisfied of thfe by obferving, that he paffes much more urine by day
 than in  the night, and alfo when he "walks or rides, than  when he
 fits.
   The circulation in the liver being flow, obftruaions  in that or-
gan can  hardly faiftobe ths confequence of inaaivity.  Hence, fe-
dentary  people are frequently afiliaed with fehirrous livers. But the,
proper fecretion and difeharge of the bile is fo neeeffevy a part of
the animal economy, that where thefe are not duly performed, the  '
health muft  foon be impaired.  Jaundice,  indigefti'on, lofs of appe-
tite,  and a waiting of the whole  body, feldom fail to be the confe- '
quences of a vitiated ftate of the liver,  or obftruaions of the bile.
   Few difeafes prove more fatal to  the ftudbqs than confumptions
of the lungs. This organ cannot  be duly expanded in thofe who
do not take proper exercife; and where that is the cafe, obftruaions
and  adhefions will enfue. Not only want of exercife, but the pok . i
 ture in which ftudious perfons generally  fit, is very hurtful to the
lungs. Thofe who read or write much are ready to contraft a ha-
bit of bending forwards, and often prefs  with their breaft upon a
 table or  beach.  This pofture hurts the  lungs. 
                AND THE STUDIOUS.               #

   The funaions of the heart may likewife by this means be in-
jured. I remember to have feen a man opened, whofe pericardium
adhered to the breaft-bone, in fuch a manner, as to obftrua the mo-
tion of the heart, and occafion his death.  The only probable caufe
that could be affigned for this fin^ular fymptom was, that the man,
 whofe bufinefs was writing, ufed conftantly to fit in a bending
pofture, with his breaft preffing upon the edge of a flat table.
   No perfon can enjoy health who does not properly digeft his
food. But intenfe thinking and inaaivity never fail to weaken the:
powers of digeftion.  Hence the folids become weak and relaxed,
and the whole conftitution goes to ruin.
   Long and intenfe thinking often occafions grievous head-achs,
which bring on vertigoes, apoplexies, palfies, and other fatal dis-
orders. The beft way to prevent  thefe is, never to ftudy too long^
at one time, and to keep the body regular, either by proper food,
or taking frequently a little of fome opening medicine.
   Thofe who read or write much are often affliaed with fore eyes*
Studying by candle-light is  peculiarly hurtful to the fight.  This
ought to be praaifed  as feldom as poffible. When it is unavoid-
able, the eyes fhould be fhaded, and the head fhould  not be held
too low.   When the  eyes are weak or painfui, they fhould bet
bathed every night and morning  in cold water, to which a little
brandy maybe added.
   The excretions are very defeaive in the ftudious.  The dropfy
ip often occeafioned by the retention of thofe humours which ought
to be carried off in this way.  Any perfon  may obferve, that fit-
ting makes his legs fwell, and that this goes off by exercife; which
clearly points out the method of prevention.
   Fevers, efpecially of the nervous kind, are often the  efifea of
ftudy. Nothing affeas the nerves fo much as intenfe thought. It
in a manner unhinges the whole human frame, and not only hurts
the vital motions, but diforders the mind itfelf. Hence a delirium*
melancholy, and even  madnefs, are often the efifea of clofe appli-
cation to ftudy. There is no difeafe  which can proceed from a
defea of the ufual fecretions, or a debility of the nervous fyftem,,
which may not be induced by intenfe thinking.
  But the moft affliaing of all the difeafes which attack the ftu-
dious is the hypochondriac. This  difeafe feldom fails to be the
companion of deep thought.  It may rather be called a complica-
tion of maladies than a fingle one.  To what a wretched condition,
are the beft of men  often reduced by it! Their ftrength and appe-
tite fail;  a perpetual gloom hangs over their minds; they live in
the conftant dread  of death, and  are  continually in fearch of re-
lief from medicine, where it is not to be found. Thofe who la-
bour under this diforder, though they are often made the fubjeai
of ridicule, juftly claim ourhigheft fympathy.
  Hafdly any thing can  be more prepofterous than for a perfon
ttr make ftudy his fole bufinefs. A mere ftudent is feldor/. an ufe-
                           H 
  58   OF THE LABORIOUS, THE SEDENTARY,

 ful member of fociety. He often negleas the moft important du-
 ties of life, in order to purfue ftudies of a very  trifling nature. It.
 rarely happens, that any ufeful invention is the effea of mere ftu-
 dy. The farther men dive into profound refearchep, they generally
 deviate the more from common fenfe, and too often lofe fight of
 it altogether.  Profound fpeculations, inftead of making men wifer
 or better, generally render them abfolute fcepties, and overwhelm
 them with doubt and uncertainty.   All that  is neceffary for man
 to know, in order to be happy, is eafily obtained ; and the reft, like
 the forbidden fruit, ferves only to increafe  his mifery.
   Studious perfons, in order to  relieve their minds, muft not only
 difeontinue to read and write,but engage in  fome employment or
 diverfion,  that will fo far occupy the thought as to make them for-
 get the bufinefs of the clofet. A folitary ride or walk are fo far from
 relaxing the mind,  that they rather encourage thought. Nothing
 can divert the mind, when it gets into a train  of ferious thinking,
 but attention to fubjeas of a more  trivial nature.  '1 hefe  prove a
 kind of play to the mind, and confequcntly relieve it.
   Learned men  often contract a contempt for what they call tri-
 fling company. They are mhamed to be feen with any but philofo-
 phers. This is no proof of their being fo.  No man deferves that
 name who is afhamed to unbend his mind, by aflbciating with the
 cheerful and gay.  Even  the fociety of children will  relieve  the
 mind, and expel the giooni which application to ftudy is too api
 to occafion.
   As ftudious people are neceffarily much within doors, they fliould
 make choice of a large and well-aired place for ftudy. This would
 not only prevent  the  bad effeas which attend confined  air, but
 would cheer the fpirits, and have a  moft happy  influence both on
 the body and mind. It is faid of Euripides, that he ufed to retire  j
 to a dark cave to compofe his tragedies, and of Demofthenes, that
 he chofe a place for ftudy where nothing could be either heard or
 feen.  With all deference to fuch venerable names, we cannot help
 condemning their tafte.  A man may furely think to as good pur-
 pofe in an elegant apartment as in a cave ;  and may have as happy
 conceptions where  the all-cheering  rays of the fun render the air
 wholefome, as  in places where they never enter.
  Thofe who read or write much fhould be very attentive to their
pofture. They  ought to fit and fland by turns, always keeping as-
nearly in an erea pofture as poffible. Thofe who diaate may do
it walking.  It  has an excellent effea frequently to read or fpeak
aloud.  This not only cxercifes the lungs, but aJmoft the whole bo-
dy.  Hence  ftudious people are greatly benefited by delivering dif-  j
courfes in public. Public  fpeakers, indeed, fometimes hurt them-
fdves by overaaing their part ;  but this is their own fault. The
martyr to mere vociferation merits no fympathy.
  The morning has been reckoned the beft time for  ftudy. «It is
fo. But it is alfo the moft proper  feafon for exercife, while the fto- 
AND THE STUDIOUS.
99
siach is empty, and the fpirits refrefhed with fleep. Studious peo-
ple fhould fometim'cs fpend the morning in walking, riding,  or
ibme manly diverfions without doors. This would make  them re-
turn to ftudy with greater alacrity, and would be of more fervice
than twice the time after their fpirits are worn out with fatigue.
It is not fufficient to take diverfion only when we can think  no
longer.  Every ftudious perfon fhould make it a part of his bufinefs,
and fhould let nothing interrupt his hours of recreation more than
thofe of ftudy.
   Mufic has  a very happy effea  in relieving the mind  when  fa-
tigued with ftudy. It would be well if every ftudious perfon were
fo far acquainted with that fcience as to amufehimfelf after fevere
thought, by playing fuch airs as have  a  tendency to raife the fpi-
rits, and infpire cheerfulnefs and good humour.
   It is a reproach to learning, that any of her votaries, to relieve
the mind after ftudy, fhould betake themfelves to the ufe of ftrong
liquors.  This indeed is a remedy ;  but it is a defperate one, and  al-
ways proves deftruaive.  Would fuch  perfons, when their fpirits
are low, get  on horfeback, and ride ten or a dozen miles, they
would find it a more effeaual remedy, than any cordial medicine,
or ftrong liquors.
   The following is my plan, and I cannot recommend a better to
others. When my mind is fatigued with'ftudy, or other ferious bu-
hnafs, I mount my horfe, and  ride ten or twelve miles into the
country, where I fpend a day, and  fometimes two, with a cheerful
friend; after which 1 never fail to return to town with new vigour,
and to purfue my fludies or bufinefs with  frefh alacrity.
   It is to be  regretted, that learned men, while in health, pay fo
little regard  to thefe things !  There is not any thing more com-
mon than to  fee a miferable objea over-run with nervous difeafes,
bathing, walking, riding, and doing every thing for health after it
is gone ; vet, if any one had recommended thefe things to him by
way of prevention, the advice would, in  all probability, have been
treated with contempt, or at leaft,  with neglea. Such is the weak-
aefs and folly of mankind, and fuch the want of forefight, even in
thofe who ought to be wifer than  others.
   With regard to the diet  of the  ftudious, we fee no reafon why
they fhould abftain from any kind of food that is wholefome, pro-
vided they ufe it in moderation. They ought, however, to be fpa-
ring in the ufe of every thing that is four, windy, rancid,  or hard
cf digeftion.  Their fuppers fhould always be light, or taken foon
in the evening. Their drink may be water, fine malt-liquor, not too
ftrong, good  cyder, wine and water, or, if troubled with acidities,
water mixed  with a little brandy, rum, or any other genuine fpirit.
   With regard to thofe kinds of exercife which are moft  proper
for the ftudious, they fliould not be too violent, nor  carried to ex-
ceffive fatigue. They ought to be frequently varied fo as to give
»aion to all the different parts of the body; and fhould,  as often as 
60                   OF ALIMENT.
poffible, be taken in the Open air. In general, riding on horfeback,
walking, working in a garden, or playing at fome aaive diverfions,
are the beft.
   We recommend the ufe of the cold-bath to the ftudious.  It will,
in fome meafure, fupply the place of exercife,  and fhould not be
negfeaed by perfons of a relaxed habit, efpecially in a warm feafon.
   No perfon ought either to take violent exercife, or to ftudy im-
mediately after a full meal.
                CHAPTER   III.

                        Of Aliment.

     UNWHOLESOME food, and irregularities in diet, occafion
      many difeafes.  There is no doubt but the whole conftitu-
tion of body may be changed by diet alone.  The folids may be
braced or relaxed, have their fenfibility, motion, &c. greatly in-
creased or diminifhed, by different kinds of aliment.  A very fmall
attention to thefe things will be fufficient to fhow,  how much the
prefervation of health depends  upon a proper regimen of the diet.
  Nor is an attention to diet neceffary for the prefervation of health
only: it is likewife of importance in the cure of difeafes.  Every
intention in the cure of many  difeafes,  may be  anfwered by  diet
alone.  Its effeas, indeed,  are not always fo quick as thofe of me-
dicine, but they are generally  more lafting : befides, it is neither
fo difagreeable to the  patient,  nor fo dangerous as medicine, and
is always more eafily obtained.
  Our intention  is not to inquire  minutely into the nature anjl
properties of the various kinds of aliment in ufe among mankind;
nor to fhow their  effeas upon the different conftitutions of the hu-
man body ; but to mark fome of the moft pernicious errors whicfc-,
people are apt to  fall into, with refpea both to the  quantity and
qualities of their food, and to point out their influence upon health.
  It is not eafy to afcertain the exaa quantity of food proper for
every age, fex,  and conftitution : but a fcrupulous nicety here is
not neceffary.  The beft rule is to avoid all extremes.  Mankind
were never intended to weigh and meafure their food.  Nature
teaches every creature when it has enough ; and the  calls of thirft
and hunger are fufficient to inform them when more  is neceffary.
  Though moderation is the ;hief rule with regard to the quantity,
yet the quality of food  merits a farther confideration.  There are""
many ways by which provifions may be rendered unwholefome.
Bad feafons may  either prevent the ripening of grain, or damage
it afterwards. Thefe,  indeed, are a&s of Providence, and we muft
fubmit to them;  but no punjfhment can be too fevere for thofe 
OF  ALIMENT.
6r
who fuffer provifions to  fpoil by hoarding them, on purpofe to
raife the price, or v\ho promote their own intereft by adulterating
the neceffaries of lifev.
   Animal, as well as vegetable food, may be rendered unwhole-
fome, by being kept too long.  All animal fubftancesdiave a con-
itant tendency to putrefaaion ;  and, when that has proceeded too
far, they not only become offenfive  to  the fenfes, but hurtful to
health.  Difeafed animals, and fuch as die of themfelves, ought ne-
ver to be eaten.  It is a common praaice in Cowc grazing countries,
for fervants and poor people ti eat fuch animals as die of difeafe,
or are killed by accident. Poverty may oblige people to do this;
but they had better eat a fmailer quantity  of what is found  and
wholefome : it would both afford a better nourifhment, and be at-'
tended with lefs danger.
   The injunaions given to the Jews, not to eat any creature which
died of itfelf, feem to have a ftria  regard to health; and ought
to be obferved by Chriftians as well as Jews.  Animals never die
of  themfelves without fome previous difeafe ; but how a difeafed
animal  fliould be wholefome food,  is inconceivable: even thofe
which die by accident muft be  hurtful, as their blood  is mixed
with the flefh, and foon turns putrid.
   Animals which feed grofsly, as tame ducks, hogs,  &c. are nei- ,
ther fo  eafily digefted, nor afford fuch wholefome nourifhment  as
others.  No animal can be wholefome which does not take fufficient
exercife.  Moft of our flailed cattle are crammed with grofs food^
but not allowed exercife nor free air; by which means they indeed
grow fat, but their juices, not being properly prepared or affimi-
iated, remain crude, and occafion indigeftiom, grofs humours and
oppreffion of the fpirits, in thofe who feed  upon them.
   Animals are often rendered unwholefome by being over-heated.
Exceffive heat caufes a fever. For this reafon, butchers  fhould be
feverely reprimanded who over-drive theircattle. No perfon would
choofe to eat the flefh c\f an animal which had died in a high fever;
yet that is the cafe with all over-drove cattle ; and the fever is of-
ten raifed even to the degree of madnefs.
   But this is not the only way by which butchers render meat un-
wholefome. The abominable cuftom of filling the cellular mem-
brane of animals with air, in order to. make them appear fat, is every
day praaifed. This not only fpoiis the meat; and renders  it unfit
for keeping, but is fuch a dirty trick, that the  very idea of  it is
fufficient to difguft a perfon'of any delicacy at every thing which


  -* The-poor are generally thr Srft  who f^ffer by unfound provisions ;
•but the lives of the labouring poor are ox great importance to the ftate ;
beiides,  difeafes occafioned by unwholefome food often prove infectious,
by which means they reach people .in every ftation.  It is therefore the
intereft of all to take" :?re th^.t no fpril: provisions of any kind be ex-
pofed to fale.   • 
62
OF ALIMENT.
comes from the (hambles.   Who can bear the thought of eating
meat which has been blown up with air from the lungs of a dirty
fellow, perhaps labouring under the very worft of difeafes ?
  Butchers have likewife a method of filling  the cellular mem-
branes of animals with blood. This makes the  meat feem fatter,
and likewife weigh more, but it is a very pernicious cuftom, as it
both renders the meat unwholefome and unfit for keeping. I fel-
dom fee a piece of meat from the fhambles, where the blood is not
diffufed through the cellular texture, I fhall not fay that this is al-  i
ways the effea of defign; but I am  certain it is not the cafe with
animals that are killed for domeftic ufe,  and  properly  blooded.
Veal feems to be moft frequently fpoilc in  this  way.  Perhaps that
may in fome meafure be owing to the praaice of carrying calves
from a great diftance to market, by which means their tender flefh
is bruifed, and many of their veffels  burft.
  No people in the world eat fuch quantities of animal food as the
Englifli, which is one reafon why they are fo generally tainted with
the feurvy and its numerous train of confequences, indigeftion, low '
fpirits, hypochoudriacifm, &c.  Animal food was furely  defigned  i
for man, and with a proper mixture of vegetables, it will  be found
the moft  wholefome ; but to gorge beef, mutton, pork,  fifli, and
fowl, twice or thrice a day, is certainly too much.  All who value
health  ought to be contented  with making one meal of flefh in
twenty-four hours, and this ought to confift of one kind  only.
  The moft obftinate feurvy has often been cured by a vegetable
diet; nay, milk alone will frequently do more in jhat difeafe than
any medicine.  If vegetables and milk were more ufed in diet, we
fhould have lef3 feurvy, and likewife fewer putrid and inflammato-
ry fevers. Frefh vegetables, indeed,  come to be daily more ufed in
diet: This laudable praaice we hope will continue to gain ground.
   Our aliment ought  neither to be  too moift nor too dry. Moift  \
aliment relaxes the folids, and renders the  body feeble. Thus, fe-
males, who live much  on tea, and other watery diet, generally be-
come weak, and unable to digeft folid food  : Hence proceed hyfte-
rics, and  all  their confequences. On the other hand, food that is
too dry, renders the folids in a manner rigid, and the humours vif-
cid, which difpofes the body to inflammatory fevers, fcurvics, and
the like.
   Much has been faid on the ill effeas of tea in diet. They are, no
doubt, numerous; but they proceed rather from the imprudent ufe
of it, than from any bad qualities in the tea itfelf. Moft delicate
perfons, who are the greateft tea-drinkers, cannot eat any thing in
the morning. If fuch  perfons, after fafting ten or twelve hours,
drink four or five  cups of tea, without eating almoft any bread it
muft hurt them. Good tea, taken in moderate quantity, not too
ftrong, nor too hot, nor drank upon an empty ftomach, will feldom
do harm ; but if it be  bad, or fubftituted in the  room of folid food
k muft have many ill effeas. 
OF  ALIMENT.                   6$
   The art^of cookery render many things unwholefome, which
 are not fo in their own nature. By jumbling together a number ot
 different ingredients, in order to make a poignant fauce or rich
 foup, the compofition proves almoft a poifon. All high feafoning,
 pickles, &c are only incentives to luxury, and hutt the ftomach. It
 were well, if cookery as an art were prohibited. Plain roafting or
 boiling is all that the ftomach requires. Thefe  alone are fufficient
 for people in health, and the fick have flill lefs need of a cook.
   The liquid part of our aliment likewife claim's our attention.
 Water is  not only the  bafis of moft liquors, but alfo compofes a
 great part of our folid food. Good water muft therefore be of the
 greateft importance in diet. The beft water is that which is moft
 pure,  and free from any mixture of foreign bodies. Water  takes
 up parts of moft bodies with which it comes into contaa ; by this
 means, it is often impregnated with metals or minerals of a hurtful
 or poifonous nature. Hence the inhabitants of fome hilly countries
 have peculiar difeafes, which in  all  probability proceed from the
 water.  Thus the people who live near the  Alps in  Switzerland,.
 and the inhabitants of the Peak of Derby, in England, have  large
 tumours or wens in their necks.  This difeafe is generally imputed
 to the fnow-water ;  but  it is rather owing to the minerals in the
 mountains through which the waters pafs.
   When  water is  impregnated  with foreign bodies, it generally
 appears by its  weight, colour, tafte, fmell,  heat, or feme other
 fenfible quality.  Our bufinefs is to choofe fuch water, for common
 ufe, as is fighteft, and without any particular colour, tafte; or fmell.
 In moft places of Britain the  inhabitants have their choice of wa-
 ter ; and few things would contribute more to  health than a due
 attention to this article.  Indolence often induces people to make.
 ufe of the water that is neareft, without confidering its qualities.
   Before  water be brought into great towns, the ftria&ft attention
 ought to  be paid to its qualities, as many difeafes  may be occa-
 fioned or  aggravated by  bad water ;  and when once procured, at.
 a great expenfe, people are unwilling to give it up.
   The common methods of rendering water clear by filtration, or
 foft, by expofing it  to the fun and air, &ec. are generally known.
 We fhall only advife all to avoid waters Which ftagnate long in fmall
 lakes,ponds,or the like; as fuch waters often become putrid,by the
 corruption of animal and vegetable bodies with which they abound.
 Even cattle frequently fuffer by drinking, in  dry feafons, water
 which has flood long in  fmall refervoirs, without being fupplied
 by fprings or frefhened with fhowers.  All wells ought to be kept
 clean, and to have a free communication with the air.
   Fermented liquors, though exclaimed againft by many writers,
 continue to be the common drink of almoft every perfon who car*
 afford them :  We  fhall rather endeavour  to aflift  people in the
choice of thofe liquors, than pretend to condemn what cuftom has
 fo firmly eftablifhed. It is not the moderate ufe of found fermented 
64                  OF ALIMENT.
 liquors which hurts mankind : Ti is excefs,.an,d ufing fuch as ar.-
 ill prepared or vitiated.
  .  Fermented liquors, which are too ftrong, hurt digeftion ; and
 the body is fo far from being ftrengthencd by, them, that it is weak-
 ened and relaxed. Many irr..;:ue th ,t hard labour could not be
 fupported without drinking ftrong liquors : This is a very errone-
 ous not%#*. Men who never tafte ftrong liquors are not only able
 to endure more fatigue, but alfo live much longer, than thofe  who
 ufe them daily.  But, fuppofe ftrong liquors did enable a man to do
 more work, they muft neverthelefs  wafte the powers of life, and
 occafion premature old age.  1 hey keep up a conftant fever, which
, cxhaufts the fyftem, and difpofes the body to numberlefs difeafes.
    But fermented liquors may be too weak  as well  as too ftrong:
 when that is the cafe, they muft be either drank new, or they be-
 come four and  dead ; when fuch liquors are drank  new, the fer-
 mentation not being over, they generate air in the bowels, and oc-
 cafion flatulencies ; and, when kept till ftalc, they four on the flo-  t
 mach, and hurt digeftion.  For this reafon, all malt-liquors, cider,
 &c. ought to be of fuch ftrength, as to keep till they are ripe, and- ,.<
 then they fhould be  ufed. When fuch liquors  are kept too long^ I
 though  they fliould not become four, yet they generally contraa a ,'
 hardnefs, which renders them unwholefome.
    All families, who  can,ought to prepare their  own liquors. Since
 preparing and vending of liquors became one of the moft general
 branches of bufinefs, every method has  been  tried to adulterate
 them. The great objea both to the makers and venders of liquor
 is, to render it  intoxicating.  But  it is well known that this may
 be done by other ingredients than  thofe  which ought to be  ufed
 for making it ftrong.  It would be imprudent  even to name  thofe
 things which are daily made ufe of to render liquors heady.  Suf-
 fice it to  fay, that the praaice is very common, and that all the
 ingredients ufed for this purpofe are of a narcotic or ftupefaaive  . 1
 quality.   But as all opiates are poifonous, it  is eafy to fee what   1
 muft be the confequence of their general ufe.  Though they do
 not kill fuddenly, yet they hurt the nerves, relax and weaken the
 ftomach, and fpoil the digeftion.
    Were fermented  liquors faithfully prepared, kept to  a proper
 age, and ufed  in moderation, they would prove real bleflings to
, mankind.  But, while they are ill prepared, various ways adulte-
 rated, and taken to excefs, they muft have many pernicious effeas.
    We recommend  it to families, not only to  prepare their own
 liquors, but their bread.   Bread is fo neceffary a part of diet, that
 too much care cannot be bellowed in order to have it  fpund and
 wholefome.  For this purpofe, it is net only neceffary that it be
  made of good grain, but likewife properly prepared, and kept free '
  from all  unwholefome ingredients.  This is  not always the cafe .s *'
  with bread prepared by thofe who  make a  ti.ule of vending it.
  Their objea* is rather to pleafc th; :y\ than to confult the health. 
OF ALIMENT.                   65
The beft  bread is that which is neither too coarfe nor too fine,
well fermented, and made of wheat flour, or rather of wheat and
rye mixed together.
  To fpecify the different kinds of aliment, to explain their nature
and properties, and to point out their effeas in different conftitu-
tions would far exceed our defign.  We fhall only mention the fol-
lowing eafy rules with refpea to the choice of aliment.
   Perfons, whofe folids are weak and relaxed, ought to avoid all vif-
cid food, or fuch things as are hard of digeftion.  Their diet ought
to  be nourifhing, and  they fhould J;ake fufficient exercife in the
open air.
   Such as abound with blood fhould be fparing in every thing that
is highly nourifhing, as fat meat, rich wines, ftrong  ale, and fuch
like. Their food fhould confift moftly of bread and other vegetable
fubftances ; and their drink ought to be water, whey, or fmall-beer^
   Fat pepple fhould not eat  lreely of oily nourifhing diet. They
ought frequently to ufe radifh, garlic, fpices, or fuch things as are
heating and promote perfpiration and urine. Their  drink fhould
be water, coffee, tea, or  the like ;  they ought to take much exer-
cife, and little  fleep. Thofe  who are too lean muft follow an op-
pofite courfe.
   Such as are troubled with acidities, or whofe food is apt to four
on the ftomach, fhould live much on animal food; and thofe afflia-
ed with hot alkaline eruaations,  ought to ufe  a diet confuting
chiefly of acid vegetables.
   People affeaed with  the  gout, low  fpirits, hypochondriac or
hyfteric diforders, ought to avoid all flatulent food, every thing that
is vifcid, or hard of digeftion, all falted or fmoke-dried provifions,
and whatever is auftere, acid, or apt to four on the ftomach.  Their
food  fhould be light, fpare, cool, and of an opening nature.
   The diet ought to be fuited to the age, conftitution, and manner
of life:  A fedentary or ftudious perfon fhould live more fparingly
 than one who labours hard without doors. Many  kinds of food will
 nourifh a peafant very well, which would be almoft indigeftible to
 a citizen ; and  the latter will live upon a diet on  which the former
 would flarve.
   Diet ought not to be too uniform. 1 he conftant ufe of one kind
 of food  might  have  fome bad effects. Nature,  teaches Us this, by
 the great variety of aliment which*fhe has provided  for man, and
 likewife by giving him an appetite for different kinds  of food.
   Thofe who  labour under any particular,difeafe, ought to avoid
 fuch aliments  as have a tendency to  increafe it: For example, a
 gouty perfon fliould not indulge in rich wines, ftrong foups or gra-
 vies, and fhould avoid all acids. One who is troubled with the
 gravel ought to fhun all auftere and aftringent aliments; and thofe
 who are fcorbutic fliould be fparing in the ufe of falted provifions.
   In the firft period of life, our food ought to be light, nourifhing,
' and frequently taken.  Food  that is folid,  with a fugigieHt degree 
 66                   OF ALIMENT.

 of ten?.cuv, is  mcft proper fir the ftate of manhood.  The diet"  \
 ffuite^ to the Iaft period of life, when nature is upon the decline,
 approaches nearly to that of the firft.  It fhould be lighter and more
 fucculent than  that of vigorous age, and likewife more frequently
 taken.
   It is not only neceffary for health that our diet be wholefome,
 but alfo that it be taken at regular periods.  Some imagine long fall-
 ing will atone for excefs , but this, inftead of mending the matter,
 generally  makes it worfe. When  the ftomach and inteftines are
 over-diftended  with food, they lofe their proper tone, and, by long
 falling, they become weak, and inflated with wind.  Thus, either
 gluttony or fafting deftroys the powers of digeftion.
   The frequent repetition of  aliment is not only neceffary for re-
 pairing-the continual wafle of our bodies, but likewife to keep the
 fluids found and fweet. Our  humours, even in the moft healthy
 ftate, have a conftant tendency to putrefaaion, which can only be  ■
 prevented by frequent fupplies of frefh nourifhment: when that is  'I
 wanting too long, the putrefaaion often proceeds fo far as to ocea-  I
 fion very dangerous fevers. From hence we mav learn the neceffi-  I
 ty of regular meals.  No  per fen can enjoy a good ftate of health,
 whofe veffels are either frequently overcharged, or  the humours-  1
 long deprived of frefh fupplies of chyle.
   Long fafting is extremely hurtful  to young people ; it not oriy
 vitiates their humours, but prevents their growth. Nor is it lefs in-
 jurious to the aged. Moft perfons, in trie decline of life, are afflia-
 ed with wind:  This complaint is not  only increafed, but rendered
 dangerous, and  often fatal, by long fafting.  Old people, when their
 ftomachs are empty, are frequently  feized with giddinefs, head-
 achs, and faintnefs. Thefe complaints may generally be removed v m
 by a piece of bread and a glafs of wine, or taking any other folid   J
 food;  which plainly points out the method of preventing them.   '  |
   Many of the  fudden deaths, which happen in the advanced pe-   I
 riods of life, are occafioned by fafting too long, as it exhaufts the
 fpirits, and fills  the bowels with wind ; we would therefore advife
 people in the declineof life, never to allow their ftomachs to be too
 long empty. Many people take nothing but a few cups of tea and
 a little bread, from nine o'clock at night till two or three next after-   '
 noon. Such maybe faid to faft almoft three-fourths'of their time.
 This can hardly fail to ruin the appetite, and fill the bowels with
 wind ; all  which might be prevented by a folid breakfaft.
   It is very common tt> eat a  light  breakfaft and a heavy fupper.
This cuftom ought to be reverfed. When people fup late, their
fupper fhould be very light; but the breakfalfought always  to be
folid.  If any one eats alight fupper, goes foon to bed, and rifes be-
times in the morning, he will be  fure to find an appetite for his
breakfaft, and he may freely indulge it.
  The ftrong and healthy do not fuffer fo much from fafting as the
 * ;ak and ddicate; but they run great hazard from its oppofite,' 
                        OF  AIR.                     -67

Viz. repletion. Many difeafes, efpecially fevers, are the effea of a
plethora, or too great fulnefs of the veffels.  Strong people, in high
health, have generally a great quantity of blood and other humours.
Yv'hcti thefe are fuddenly increafed,  by an overcharge or rich and
nourishing diet, the veffeis become too much diftended, and  ob-
ltru( lions and inflammations enfue. Hence fo many people arefeiz-
cd with inflammatory and eruptive fevers after a feaft or debauch.
   All great and fudden changes in diet are dangerous. What the
ftomach has been long accuftomed to digeft, though lefs whole-
tbmc, will agree better with it than food of a more falutary nature
which it has not been ufed to. When a change becomes neceffary,
it ought to be made gradually ;  a fudden  tranfition from a poor
and  low, to a rich and luxurious diet, or the contrary, might fo
diiturb the funaions of the  body, as to endanger health, or even to
occafion^feath itfelf.
   When we recommend  regularity in diet, we condemflBnot every
fmail deviation.  It is next to impoflible for people at all times to
avoid fome degree of excefs,  and  living  too  much by  rule might
make even the fmalleft deviation dangerous.  It may be prudent
to vary a little, fometimes  taking more, fometimes lefs, than the
ufual quantity of meat and  drink.,  if  due regard be had  to modera-
tion.
                 CHAPTER   IV.


                          Of Air.

     UNWHOLESOME air is a very common caufe of difeafes.
      Few are aware of the danger arifing from it.  People gene-
rally pay fome attention to what they  eat and drink, but  feldom
regard what goes  into the lungs, though the latter often  proves
more fuddenly fatal than the former.
  Air, as well as water, takes up  parts  of moft bodies with which
it comes into contaa, and is  often fo repleuifhed with thofe of a
noxious quality, as to occafion  immediate death. But fuch violent
effeas feldom happen, as people are generally on their guard againft
them. The lefs perceptible influences of bad  air, prove more ge-
nerally hurtful to mankind ; we fhall point out fome of thefe, and
fhow from whence the danger  chiefly arifes.
  Air may become noxious  many ways. Whatever greatly alters
its degreeof heat, cold, moilture, &c.renders it unwholefome. Ve-
ry cold air obftruas the perfpiration, conftringes the folids, and
occafions rheumatifms, coughs, and catarrhs, with other difeafes
of the throat and breaft.  Air that is too moift deftroys the clafti- 
68
OF AIR.
city or fpring of the folids, induces phlegmatic or lax conftitutions,
and difpofes the body to agues; or intermitting fevers, dropfies, &c.'
   Wherever great numbers of people are crowded into one place,
if the air has not a free circulation, it foon becomes unwholefome.
Hence it is that delicate perfons are fo apt to turn fick or faint in
crowded churches, affemblies, or any place where the air is in-
jured by breathing, fires, eandles, or  the like.                     ,
   In great cities, fo many things tend to contaminate the air^ that   I
it is no wonder it proves fo fatal to  the inhabitants.  rl he air in
cities is not only breathed repeatedly over,  but is likewife loaded
with fulphur, fmoke, and other exhalations, befides the vapours
continually arifing from innumerable putrid fubftances,  as dung-
hills, flaughter-houfef,  &c.  All poffible care fhould be taken to
keep the ftreets of large towns open  and wide, that the air may
have a free current through them. They ought likewife to be kept
very clefti.  Nothing tends more to pollute the air of a city than
dirty ftreets.
   It is very common in this country  to have church-yards in  the
middle of populous cities. Whether this be the effea of ancient
fuperftition, or owing to the increafe  of fuch towns, is a matter of
no confequence. Whatever gave rife to the cuftom, it is a bad one.
Habit alone reconciles us to thefe things; by means of which  the
moftridiculous,nay,perniciouscuftoms,oftenbecomefacred. Thou-
fands of putrid carcaffes, fo near the furface of the earth, in a place
where the air is confined, cannot fail to taint it; and fuch air, when
breathed into the lungs, muft occafion difeafes*.
   Burying within churches is a praaice flill more deteflable. The
air in churches is feldom good, and the effluvia from putrid car-
caffes muft render it flill worfe. Churches are commonly old build-  ,
Jngs with arched roofs. They are  feldom opened above once a
week, are never ventilated by fires  nor open windows, and rarely  '
kept clean. This occafions that damp, mufty, unwholefome  fmell
which one feels upon entering a church, and renders it a very un-
fafe  place for the weak and valetudinary. Thefe inconveniences
might, in a great meafure, be obviated, by prohibiting all perfons
from burying within churches,  by keeping them clean, and permit-
ting a ftream of frefh air to pafs frequently through them, by open-
ing oppofite doors and windows.
   Wherever air ftagnates long, it becomes unwholefome. Hence
perfons  confined in jails not only contraa malignant fevers them-
felves,  but often communicate them to others. Nor are man'/- of
the holes, for we cannot call them houfes, poffeffed by the poor
in great towns, much better than jails. Thefe low  dirty habitations


-  4*  In moft eaftern countries, it was cuftomary to bury the dead at fome
diftance from any town.  As this praftice.obtained among the Jews, the
Greeks,  and alfo the Romans, it is ftrange that the weftern parts of Eu-
rope fliould not kavefollowed their example in a cuftom fo truly laudable.  - 
                        O F  A I R.                     6?

 ate the very lurking-places of bad air and contagious difeafes. Such
 as live in them feldom enjoy good health; ^nd their children com-
 monly die  young. In the choice of a houfe, thofe who have it m
 their power ought to pay the greateft attention to open free air.
   The various methods which luxury has invented to make houfes
 clofe and warm, contribute to render them unwholefome. No houfe
 can be wholefome unlefs the air has a free paffage through it. For
 which reafon, houfes ought daily to be ventilated, by opening op-
 pofite windows, and admitting a current of  frefh air into every
 room. Beds, inftead of being made up as foon  as people rife out
 of them, ought to be turned down, and  expofed  to the frefh air
 from the-open windows through the day. This would expel any
 noxious  vapour, and promote the health of the inhabitants.
   In hofpitals, jails, mips,  &c.  where that cannot be conveniently
 done, ventilators fhould be ufed. The  method of expelling foul,
 and introducing frefh air, by means of ventilators, is a moft falu-
 tary invention, and the moft ufeful of ail modern medical improve-
 ments. It is capable of univerfal application, and is  fraught with
 numerous advantages, both to thofe in  health and ficknefs. In all
 places where numbers of people are crowded together, ventilation
 becomes abfolutely neceffary.
   Air which ftagnates in mines, wells, cellars, &c.,is extremely
 noxious, and ought to be avoided as the moft deadly poifon.  It of-
 ten  kills almoft as quickly as  lightning.  For this reafon, people
 fhould be very cautious in opening cellars that have been long fhut,
 or going down into deep wells  or pits,  efpecially if they have been
 kept clofe covered*.
   Many people who have fplendid houfes, choofe to fleep in fmall
 apartments. This is very imprudent. A bed-chamber ought always
 to be well aired ; as it is generally occupied in the night only, when
 all doors and windows are fhut. If a fire be kept in it, the danger
 from a fmall room becomes  ftill greater.  Numbers have been ftifled
 when afleep by a fire in a fmall apartment, which is always hurtful.
  Thofe who  are obliged, on account of bufinefs, to fpend the day
 in clofe towns, ought, if poffible, to fleep  in the country.  Breath-
 ing free ahr  in the night will,  in fome meafure, make up for the
 want of  it  through the day. This praaice would have a greater
 effea in prcferving the health of citizens  than is commonly ima-
 gined.
  Delicate perfons ought, as much as poffible, to avoid the air of
great towns. It is peculiarly hurtful to the aftmatic and confump-
 tive.  Such perfons fhould avoid cities  as they would the plague.

  ■5f  We  have frequent accounts of perfons who lofe their lives by going
down into deep wells and other places where the air ftagnates ; all thefe
accidents might be prevented  by only letting down a lighted candle be„
f;»re them, and  flopping when they perceive  it go out;  yet this fimple
precaution is feldom ufed. 
~o                    OF  AIR.
 The hypochondriac are likewife much hurt by u.  Perfon.-;, fo mud)
 affliaed with this malady while in town, that it feemed impoflible
 for them to live, have, upon removing'to the country, heen imme-
 diately relieved.  The  fame obfervation holds as to nervous and hy-
 fteric women. Many people have it not in their power to change
 their fituation in queft of better air.  All we can fey to fuch perfons
 is, that they fhould go as often abroad into the  open air  as  they
 can, that they fhould admit frefh air frequently  into their houfes,
 and take care to keep them very clean.
   It was neceffary in former times, for fafety, to furround cities,
 colleges, and even fingle houfes, with high walls. Thefe, by ob-
, ftruaing the free current of air, render fuch places damp and un-
 wholefome.   Proper attention to air  and cleanlinefs would tend
 more to preferve the health of mankind, than all the endeavours
 of the faculty.
   Surrounding houfes too clofely with planting, or  thick wood?,
 likewife tends to render the air unwholefome. Wood not only ob-
 ftruas the free cunent of air, but fends  forth great  quantities of'(
 moift exhalations, which render it conftantly damp.  Wood is ve-
 ry agreeable at a proper  diftance  from a houfe, but  fhould never
 be planted too near it, efpecially in a flat country. Many gentle-
 men's feats in England are very unwholefome from the great quan-
 tity of wood which furrounds them.
   Houfes fituated in low marfhy  countries, or near large lakes of
 ftagnating water, are likewife unwholefome. Waters which ftag-
 nate not only render the air damp, but load it with putrid exhala-
 tions, which produce the moft  dangerous and fatal difeafes.  Thofe
 obliged to inhabit marfhy countries, ought to make choice of the
 drieft  fituation they can  find,  to  live  generoufly,  and to pay the
 flriaeft regard to cleanlinefs.
   If frefh air be neceffary for thofe  in health, it is ftill more fo for
 the  fick, who  often lofe their lives for want of it.  The notion that
 fick  people muft be kept very hot, is  fo  common, that one can hard-
ly enter the chamber where a patient lies, without being ready to
 faint, from the hot fuffocating fmell.  How this muft affea the
 fick  any one may judge.   No medicine is fo beneficial to the fick
as frefh air.  It is the moft reviving of  all  cordials, if adminiftered
with prudence.   We  are not  to  throw open doors and windows
at random upon the fick.  Frefh  air is to be let into  the chamber
gradually, and, if poffible, by opening the windows of fome other
apartment.
   The air of a fick perfon's chamber may be greatly frefhened,
and  the patient much revived, by fprinkling  the'floor, bed, &c!
frequently  with vinegar, juice of lemon,, or any  other ftrong ve-
getable acid.
   Where numbers of fick are  crowded into the fame houfe or
into  the  fame apartment, the frequent admiffion of frefh air'be-
comes abfolutely neceffary.  Infirmaries, hofpitals, &c. are often* 
                    OF EXERCISE.                   7i

 *■? idered fo obnoxious, for  want of proper ventilation,  tliat the
 fick run more hazard from them than  from the difeafe.  This is
 particularly the cafe when putrid fevers, dyfenteries, and other
 infeaious difeafes prevail.
   Phyficians, furgeons, and  others who attend hofpita's,  ought,
 for their own fafe-ty, to take c:ire that they be properly ventilated.
 Such perfons as are obliged to fpend moft of their time amongft
 the  fick, run great hazard of being themfelves infeaed when the
 air  is bad.  All hofpitah, and places of reception for the  fick,
 ought to have an  open fituation, at fome diftance from any great
 town, and patients  under an  infeaious difeafe ought never to
 come near the reft.


 ----------___________________________:_________________«_____


                  CHAPTER  V,


                        Of Exercife.

       MANY people look upon the neceffity man is under of earn-
        ing his bread by labour, as a curfe. But it is evident from
 the ftruaure  of the body, that exercife is not lefs neceffary than
 food for the prefervation of health : thofe whom poverty obliges
 to labour for daily  bread, are  not only the moft healthy, but gene-
 rally the moft happy part of  mankind.   Induftry feldom fails to
 place fuch above want, and aaivity ferves them inftead of phyfic.
 This is peculiarly the cafe with thofe who live by the culture of
 the ground.  The  great increafe of inhabitants in infant colonies,
 and the longevity of  fuch as follow agriculture every where, prove
 it to-be the moft healthful as well as the moft ufeful employment.
   The love of aaivity flows  itfelf very early in man.  So ftrong
 is  this principle, that a healthy youth cannot be reftrained from,
 exercife, even by the fear of pimifhment.  Our love of motion is
 a ftrong  proof of its  utiliiy.   Nature implants no difpofition in
 vain.   It feems to  be a law throughout the animal  creation, that
 no creature, without exercife, fhould enjoy health,  or  be  able to
find  fubfiftenee.  Every  creature, except m m, takes what is ne-
 ceffary.   He  alon^, and  fuch animals as arc  under his direaion,
 deviate from this original law, and they fuffer accordingly.
  Inaaivity never fails to  induce an univerfal  relaxation of the
folids, which difpofes the body  to innumerable difeafes-  When
the folids are  relaxed, neither the digeftion, nor any of the fecre-*
tions, can be  duly performed.   In this cafe, the worft confequen-
ces muft enfue.  How can perfons  who loll all the day in eafy
chairs, and fleep all night on,beds of down, fail to be relaxed 3 
7*                 OF EXERCISE.
 Nor do fuch greatly mend the matter, who never ftir abroad but
 in a coach, fedan, or fuch like.  Thefe elegant pfeces of luxury are
 become fo common, that the inhabitants of great towns feem  to be
 in fome  danger of lofing the ufe of their  limbs altogether.   It is
 now below  any one to walk, who can  afford to be carried.  How
 ridiculous would it  feem, to a perfon unacquainted with modern
 luxury, to behold the young and healthy fwinging along on the
 fhoulders of their fellow-creatures !  or to fee a fat carcafe, over-
 run with  difeafes occafioned  by inaaivity, dragged  through the
 ftreets by half a dozen horfes* !
   Glandular obftruaions, now  fo  common,  generally proceed
 from inaaivity. Thefe are the moft obftinate of maladies. So  long
 as the liver, kidnies,  and other glands, duly perform their func-
 tions, health is feldom impaired; but when they fail,  nothing can
 reftore rt. Exercife is almoft the only cure we know for glandular
 obftruaions ; indeed, it does not always fucceed as a remedy ; but
 there is reafon to believe that it would feldom fail to prevent thefe
 complaints,  were it  ufed in due time.  One thing is certain, that,
 amongft thofe  who  take fufficient exercife, glandular, difeafes are
 very little known ; whereas the indolent  and inaaive are feldom
 free from them.
   Weak nerves are the conftant companions of inaaivity. Nothing
 but exercife and open air can brace and ftrengthen the nerves, or
 prevent the endlefs train of difeafes which proceed from a relaxed
 itate of thefe organs. We feldom heir the  aaive or laborious com-
 plain of nervous difeafes; thefe are referred for the fons of eafe and
affluence. Many have been completely cured of thefe'diforders by
 being reduced from a ftate of opulence, to labour for their daily
 bread.  This plainly points out the fources from whence nervous
difeafes flow, and the means by which they may be prevented.
   It is ahfolutely impoflible to enjoy health, where the perfpira-
 tion is  not duly carried on; but that can never be the cafe where
exercife is negleaed. When the matter which ought to be thrown;
 off by perfpiration is retained in the body,  it occafions fevers, rheu-
 matifm, &c. Exercife alone would prevent many of thofe difeafes
which  cannot be cured, and would remove others where medicine
proves ineffeaual.
   Doctor Cheyne fays, that the weak and valetudinary ought to
 make exercife  a part of their religion. We recommend this not
 only to the weak and valetudinary, but to all thofe whofe bufinefs
 does not oblige them to take fufficient exercife,  as fedentary artifi-


  #  It is not neceffity, but fafliion, which makes the  ufe of carriages
 fo common.  Many  people have not exercife  enough to keep their
 humours txom ftagaation, who yet dare not venture to make a vifit to
their next neighbours, but in a coach or fedan, left they fliould be look-
 ed down upon.  Strange, that men fhould be fuch fools as to be laughed
 out Of the ufe of their limbs, or to throw away their health, in order
 to gratify a piece of vanity, or to comply with a ridiculous fafliion ! 
                      OF EXERCISE.'                   75

  ters*, (hop-keepers, ftudious perfons, &c. Such ought to tife ex-
  ercife as regularly as they take food. This might generally bt done
  without any interruption to bufinefs or real lofs of time.
    No piece of indolence hurts the health more than the modern
  cuftom of lying a-bed too long in the morning.  This is the general
  praaice in great towns.  The inhabitants of cities feldom rife be-
  fore eight or  nine  o'clock; but the morning is undoubtedly the
  beft time for exercife,  while the ftomach ir.  empty, and  the body
  refrefhed with fleep. Befides, the mornirtg-air braces and ftrength -
  ens the nerves, and, in fome meafure,anfwers the purpofe of a cold-
  bath. Let anyone .who has been accuftomed to lie a-bed till eight
  or nine o'clock,  rife by fix or feven, fpend  a couple of hours in
  walking, riding, or any aaive diverfion without doors, and he will
  find his fpirits'cheerful and ferene through the day, his appe-
  tite  keen,  and his body braced  and  ftrengthened.  Cuftom foon
  renders early-rifing agreeable, and nothing contributes more to the
  prefervation of health.
   The inaaive are continually complaining of pains of the fto-
  mach, flatulencies, indigeflions,  Sec.  Thefe complaints, which
  pave the way to many others, are not  fo  be removed  by  medi-
  cines.   They can only be cured by a vigorous courfe of exercife,
  to which indeed they feldom  fail to yield.
   Exercife, if poffible, ought  always to be  taken in the  open air.
 When that cannot be done, various methods may be contrived for
 exercifing the body within doors, as the dumb-bell, dancing, fwing-
 ing, &c.  It is not neceffary to adhere ftriaiy  to any particular
 kind of exercife.  The beft way is to take them by turns, and to
 ufe that longeft which is moft fuitable to the ftrength and confti-
 tution.  Thofe kinds of exercife which give aaion to moft of the
 bodily organs, are always to be  preferred, as walking, running,
 rid'ng, fencing, digging, fwimming, and fuch like.
   It is much to be regretted, that aaive and manly diverfions are
 now fo  little  praaifed.   Diverfions  make people take more ex-
ercife than th^y  otherwife would do, and are of the greateft fer-
 vice to fuch as are not under the neceffity of labouring for their:


   * Sedentary  occupations ought  chiefly to be  followed by vq^nen.
They bear confinement much better than men, and are fitter for every
kind of bufinefs which does not require much ftrength. It is ridiculous
Enough to fee a lufty fellow making pins,  needles,-or watch.wheels,
while many of the laborious parts of husbandry  are carried on by the
other fex. We want men for laborious emplo3'ments, while one half of
the other fex are rendered ufelefs for want of occupations fuited to thejr
ftrength, &c.  Were girls bred to mechanical .employments, we would
not fee fuch numbers  proftitute  themfelves for bread, nor find fuch a
want of men for the important purpofes of navigation, agriculture, &c
An eminent filk manufacturer told  me, that he found women anfwer
better for that bufinefs than men ; and that he had lately taken a great
many girls apprentices as filk-weavers. I hope this example will be foL
lowed by many others^ 
74                  OF EXERCISE.

bread.   As aaive diverfions lofe ground, thofe of a fedentary kind
feem to prevail.  Sedentary diverfions are of no other  ufe but to
confume time.   Inftead of relieving the mind,they often require
more thought than either ftudy or bufinefs.   Every thing that
induces people to fit ftill, unlefs it be fome neceffary employment  ,
ought to be avoided.                                          'J
   The  diverfions which  afford  the  beft exercife are, hunting,
(hooting, playing at cricket, hand-ball,  &c.  Thefe  exercife the
limbs,  promote perfpiration, and the other fecretions. They like-
wife ftrengthen the lungs, and  give  firrhnefs and agility to  the
whole body.
   Such as can, ought to fpend two or three hours a-day on horfe-
back;  thofe who cannot ride,  fhould  employ tlu: fame time in
walking.  Exercife fhould never be  continued  too long.  Ovei-
fatigue prevents the benefit of exercife, and inftead of ftrengthen-
ing the body, tends to  weaken it.
   Every man fhould lay himfelf under fome fort of neceffity to take
exercife. Indolence, like other vices when indulged, gains ground,
and at length becomes agreeable. Hence, many who were fond of
exercife in the early part  of life, become quite averfe  from it af-
terwards. This  is the cafe of moft hypochondriac and gouty peo-
ple, which renders their difeafes in a great meafure incurable.
   In fome countries, laws have been  made, obliging every man, of
whatever rank, to learn fome mechanical employment.  Whether  (
fuch laws were defigned for the prefervation of health, t>r the en-
couragement of manufaaures, is of no importance. If gentlemen
were frequently to amufe  and exercife themfelves in this way, it
might have many good effeas.  They would  af leaft, derive as
much  honour from a  few maftcrly fpecimens of their  own work-
manfhip, as  from the character of having  ruined moft of their
companions  by  gaming or drinking.  Befides,  men of leifure, by
applying themfelves to the mechanical arts, might improve them,
to the great benefit of fociety.
   Indolence not only occafions difeafes, and renders men ufelefs
to fociety, but promotes all mannei of vice.   To fay a man is idle,
 is little better than calling him vicious. The mind, if not engaged
in fome ufeful purfuit, ia conftantly in queft of idle pleafures, or
 impjjffed with  the apprehenfion of fome imaginary evil.  From
 thefe fources proceed moft of the miferies of mankind. Certainly
 man was never  intended to be idle.  Inaaivity fruftrates the very
 defign of his creation ; whereas an aaive life is the beft guardia* V
 cf virtue, and the greateft preservative of health. 
[   75   ]
                CHAPTER  VI.

                  Of Sleep  and  Clothing.
   SLEEP, as well as diet, ought to be duly regulated.  Too little
   .  fleep weakens the nerves, exhaufts the fpirits, and occafions
difeafes ; and  too much  renders the mind  dull, the body grofs,
and difpbfes to apoplexies, lethargies, and other complaints of a
fimilar nature.  A medium ought to be obferved ; but this is not
eafy  to fix.  Children require  more fleep than grown perfons, the
laborious than the idle, and fuch as eat and drink freely, than thofe
who live abftemioufly. Befides, the real quantity of fleep cannot
be mcafured by time ; as  one perfon will be more refreflied by five
or fix Iiouts. of fleep, than another by eight or ten.
  Children may always be allowed to  take as much fleep as they
pleafe j but, for adults, fix or feven hours is certainly fufficient,
and  no one ought to exceed  eight. Thofe who lie a-bed more
than eight hours may number, but they can hardly be faid to fleep 5
fuch generally tofs and dream  away the fore-part of  the night,
fink to reft towards morning, and doze till noon.  The beft way
to make fleep found and refrefhing is to rife betimes. The cuftom
of lying a-bed for nine or ten hours, not only makes the fleep lefs
refrefiling, but relaxes the folids, and greatly weakens the confti-
tution.
   Nature points out night as the proper feafon for fleep. Nothing
more certainly deftroys the conftitution than night-watching.  It
is great pity that a praaice fo deftruaive to health fhould  be fo
much in fafhion. How quickly the want of reft in due feafon will
blaft the moft blooming complexion, or ruin the beft conftitution,
is evident  from the ghaftly countenances of thofe, who, as the
phrafe  is, turn day into night, and night into day.
   To  make fleep  refrefhing, the following things are requifite :
Firft, to take  fufficient exercife in  the  open air 5 to avoid ftrong
tea or coffee j next,  to eat a light fupper ; and laflly, to lie down
 with a mind as cheerful  and ferene as poffible.
   It is certain that too much  exercife will prevent fleep, as well as
 too  little.   We feldom  however hear the aaive and laborious
complain of reftlefs nights.  It is the indolent and flothfuPwho
 generally have thefe complaints.   Is it any wonder that a bed of
down fhould  not be refrefhing to  a perfon who fits all day in an
 eafy chair ? A great part of the pleafure of fife confifts in alternate
 Beft and motion ;  but they who neglea the latter can never relifh
fhe  former.   The labourer enjoys  more true luxury in plain food
 and found fleep, than is to be  found in fumptuous tables and
 downy pillows, where exercife is wanting.
   That light fuppers caufe found  fleep, is true even to a proverb.
 Many  perfons, if they exceed the leaft at that meal,  .re fure to
 have uneafy nights 5 and, if they fall afleep, the load and oppreffion 
 ;6           OF  SLEEP AND CLOTHING.

 on their ftomach and fpirits occafion frightful dreams, broken and
 difturbed repofe, the night-mare, &c.  Were the fame perfons to
 go to bed with a light fupper, or fit up till that meal was pretty
 well digefted, they would enjoy found fleep, and rife refreflied and
 cheerful.  There are indeed fome people who cannot fleep unlefV
 they have ate fome  folid food at night, but this does not imply the
 neceffity of a heavy fupper ; befides, thefe are generally perfons
 who haye accuftomed themfelves to  this method, and who do not
 take a fufficient quantity of folid food and exercife.
   Nothing more certainly difturbs our repofe than anxiety. When
 the mind is not at  eafe, one feldom enjoys found fleep.   That
 greateft of human bleflings flies the  wretched, and vifits the  hap-
 py, the cheerful, and  the gay.   This is a fufficient  reafon  why .
 every man fliould endeavour to be as eafy in his mind as poffible
 when he goes to reft.   Many, by  indulging  grief and anxious
 thought, havebanifhed found fleep fo long, that they coujd never
 afterwards enjoy it.  '
   Sleep, when taken in the fore-part of the night, is generally
 reckoned moft refrefhing.  Whether this be the effea of habit or
not, is hard  to fay;  but as moft people are accuftomed to go early
 to bed when young, it may be prefumed that fleep, at this feafon,
 will prove moft refrefhing to them ever after. Whether the fores- .
 part of the night be beft. for fleep or not, furely the fore-part of the
 day is fitteft both for bufinefs and amufement. I hardly ever knew
 an early rifer who did not enjoy a good ftate of health*.
                        Of Clothing.

   THE clothing ought to be fuited to the climate. Cuftom has .
a very great influence  in this artilcle ; but  no  cuftom can ever
change the nature of things  fo far, as to render the fame clothing
nt for an inhabitant of Nova Zembla and Jamaica.   It is not nc-
ceflary to obferve  an exaa  proportion betwixt  the  quantity of
clothes v/e wear, and the decree of latitude which we inhabit;
but, at the fame time,  proper attention  ought to be  paid it, as
welL»s to the  opennefs of the country, .the frequency and vio-
lence of ftorms, &c.
  hi  youth, while the  perfpiration is  free, it is  lefs neceiTary to
cover the body with a  great  quantity of clothes ; but, in the de-
cline of life, v/hen the  fkin becomes rigid, the clothing fhould be
jhicreafed. Many difeafes in  the latter period of life proceed from
a'defea of perfpiration  ; thefe may, in fome meafure, be prevent-

  * Men of every occupation,  and in every fituation of life, have lived
-,o a good old age ;  nay, fome have enjoyed this bleffing whofe plan of
aving  was by ho means regular :  but it confilts with  obfevvation. that
„,;;  i cry old men have been early rifers.  This is the only circuiuftancg
fcttcmling longevity, to whkh I newer knew an exception,        '  ,' 
OF  SLEEP  AND  CLOTHING.
ed by a fuitable addition to the clothing, or by wearing fuch as
are better calculated for promoting the difeharge from the tkm,
as clothes made of cotton, flannel, &c.
   The clothing ought to be fuited to the feafon of the year. Clo-
thing may be warm enough for fummer,  which is  not fufficient
for winter.  The  greateft  caution is neceffary in making thefe
changes.  We ought  neither to put off our winter clothes too
foon, nor to wear our fummer ones too long.  In this  country,
the winter often fets in  very early with great vigour, and we have
frequently  cool weather even after the  commencement of the
fummer months..  It would likewife be prudent  not to make the
change all at once, but to do it gradually -,  and indeed the changes
of apparel in this climate ought to be very inconfiderable, elpeci-
ally among thofe who have paffed the meridian of life .
   Clothes often become hurtful by their being made fubiervient
to the purpofes of pride or  vanity.  Mankind in all ages have con-
fidered clothes in  this view, their fafhion and figure have been
continually  varying, with very little regard either  to health, cli-
mate, or conveniency.
   Even the human fhape ia often attempted to be mended  by
 drefs, and thofe who  know no better believe that mankind womd
 be monfters without  its affiftanee.  All attempts  of this nature
 are highly pernicious. The moft deftruaive of them in this coun-
 try is that of fqueezing the ftomach and bowels into as narrow a
 compafs as poffible, to procure, what is falfely called a fine fhape.
 By this praaice the aaion  of the ftomach and bowels, the motion,
 of the heart and lungs, and  almoft all  the vital fundiions, are ob-
 ftruaed.  Hence proceed indigeflions, fyncopes, or fainting fits,
 coughs, confumptions.of the lungs, and other complaints fo com-
 mon among females.                                    ,
    The feet likewife bften fuffer by preffure. How a fmall foot
 came to be reckoned genteel, I  will not pretend to fay j  but this
 notion has made many  perfons lame.  Almoft nine-tenths of man-
 kind are troubled with corns;  a difeafe  that is feldom or never
 occafioned  but by ftrait fhoes.   Corns are not only very trouble-
 fome, but, by rendering people unable to walk, they may hkewiic
 be confidered as the remote caufe of other difeafesf.


   * Th»t colds kill more  tl?an plagues, is an old obfervation : and.
 with  regard to this country,  it holds ftriftly true.  Lyery perfon of
 difcernment, will  perceive,  that moft of the colds which prove fo def-
 truaive to me inhabitants/are owing to  their imprudence in changing
  clofhes A few warm days in  March or April induce them to throw off
  their winter garments,  without confidering that our moft penetrans.g
  colds generally happen in May.
    * We often fee perfons quite lame by the nails of their toes having
  «rowa into the fle£ and frequently hear of mornficaVon« ^fne*£.
  from this caufe. AlUhefe, and many other inconveniences attending the
  feet  muft be imputed folely te the ufe of lhort and i.rait dioes, 
78           OF  SLEEP AND CLOTHING.

  The fize and figure of the flioe ought certainly to be adjp'ed i<-
the foot.  In children the feet are as well fliapcd as the hands.,
and the motion of the toes as free and eafy as that of the fingers;
yet few perfons in the advanced periods of life arc abfe to  make
any ufe of their toes. They are generally, by narrow fhoes, fqueexed
aU-of-a-heap, and often laid over one-another in fuch a manner as
to be rendered  altogether incapable of motion.   Nor  is the high
heel lefs hurtful than the narrow toe.   A lady may feem taller for
walking on her tiptoes, but fhe will never walk well in this man-
ner.   It flrains her joints, diftorts her  limbs, makes her floop,
and utterly deftroys all her eafe and gracefulnefs of motion : It is
entirely owing to fhoes with high heels and narrow toes, that not
one female in ten can be faid to walk well.
  In fixing on the clothes, due care fhould be taken to avoid all
tight bandages.  Garters, buckles,  &c. when drawn too tight, not
only prevent the free motion and ufe of the parts about which they
are bound, but likewife obftrua the circulation of the blood, which
prevents the equal nourifhment and growth of thefe parts, and oc-
cafions various difeafes. Tight bandages about the neck, as flocks,
cravats, necklaces, &c. are extremely dangerous. They obftrua the
blood in its courfe from the brain, by which means head-achs, ver-
tigos, apoplexies, and other fatal difeafes are often occafioned.
  The perfeaion of drefs is to be eafy and clean.  Nothing can be
more ridiculous, than for any one  to make himfelf a flave to fine
clothes. Such an one, and many fuch there are, would rather re-
main as fixt as aftatue from morning till night, than difcompofe a
fingle hair or alter  the pofition of a pin.  Were we to recommend
any particular pattern for drefs, it would be that which is worn by
the fociety of Friends, commonly called Quakers. They are always
neat, clean, and often  elegant, without any thing fuperfluous.
What others lay out upon tawdry  kces, ruffles and ribbands, they
befiow upon fuperior cleanlinefs.  Finery is only the affeaation of
drefs, and very often  covers a great deal of dirt.
  Clothing ought  not only to be fuited to the climate, the  feafon
of the year, and the period of life ; but likewife to the temperature
and conftitution. Robuft perfons are able to endure either cold or
heat better than the delicate j  confequently, may be lefs attentive
to they clothing. But the  precife quantity of clothes neceffary for
any perfon cannot be determined by reafoning.  It is entirely a mat-
ter of experience, and every man is the beft judge for himfelf,
what quantity of clothes is neceffary to keep him warm*.


  * Boerhaave ufed to fay, that no-body fuffered by cold, fave fools
and beggars ; the latter not being able to procure  clothes, and the for-
mer not having fenfe to wear them. In many cafes where the powers of
medicine had been tried in  vain, I have cured the patient by recom
mending thick fhoes, a flannel waiftcoat and drawers, a pair of under
ftockings, or a flannel petticoat, Co be worn during the told feafon at le?v» 
[79   3
                  CHAPTER   VII.

                     Of Intemperance.

     ROUSSEAU obferves, that temperance and exercife are the
      two beft phyficians. He might have added, that if thefe were
duly regarded, there would be little occd-.on for any other. Tem-
perance may juftly be called the parent of health -, yet numbers of
mankind aa as if they .thought difeafes and death too flow in their
progrefs, and by intemperance and debauch feem to folicit their
approach.
  The danger of intemperance appears from the very conflruaion
of the human body. Health depends on that ftate of the folids and
fluids which fits them for the due performance of the vital func-
tions  ; and while thefe go regularly  on,  we  are found and well;
but whatever difturbs them,  neceflarily impairs health.  Intempe-
rance never fails  to diforder the whole animal economy :  It hurts
the  digeftion, relaxes the nerves,  renders the different fecretions
irregular, and occafions numberlefs difeafes.
  The analogy between the nourifhment  of plants and animals af-
fords  a ftriking proof of the danger of intemperance.  Moiftureanci
manure greatly promote vegetation ; yet an over-quantity of either
will entirely deftroy it.  The  beft things become hurtful, nay, de-
ftruaive, when carried to excef;.  Hence we learn that the higheft
degree of human wifdom confiits  in regulating our  appetites and
paffionsfo as to avoid all extremes. It is that chiefly which entitles
us to  the charaaer of rational beings. The flave of appetite is the
difgrace of human nature.
  The Author of Nature hath endued  us with various pafiions,
for  the propagation of the fpecies, the prefervation of the indi-
vidual,  &c.  Intemperance  is the abufe of  thefe paffions ; and
moderation confifts in the  proper regulation of them.  Men, not
contented with fatisfying the fimple calls of Nature, create arti-
ficial  wants, and are perpetually in fearch of fomething that may
gratify them ; but imaginary  wants never can be gratified. Nature
is content with little ; but luxury knows  no bounds. Hence the
epicure, the drunkard, and the debauchee, feldom flop in their ca-
reer,  till their money or their conftitution fails: Then indeed they
fee  their error when too  late.
  It is impoflible to lay down fixt rules with regard to diet, on ac-
count of the different conftitutions of mankind. The  moft ignorant
perfon, however, certainly knows what is meant by excels ; and
every man, if he  choofes, can avoid it.
  The great rule of diet is to ftudy fimplicity. Nature delights in
the  moft fimple  food, and every animal, except man, follows her
diaates. Man alone riots at large, and ranfacks the whole creation
in queftof luxuries, to his own  deftruaion. "For my part," fays Ad- 
  8o             OF INTEMPERANCE

  difon, "when I behold a fafhionable table fet out in all its magnifi-
  cence, I fancy that I fee gouts and dropfies, fevers and lethargies,
  with other innumerable diftempers, lying in ambufeade among the
  difhes."
   Nor is intemperance in other things lefs deftruaive than in diet,
 *Ho# quickly does the immoderate purfuit of carnal pleafures,or the
 abufe of intoxicating liquors, ruin the beft conftitution! Thefe vices
 generally go hand in hand. Hence we fo often behold the Votaries
 of Bacchus and Venus, even before they have arrived at the prims
 of life, worn out with difeafes,  and hafting with fwift pace to an
 untimely grave. Did men reflea on the painful difeafes, and prema-
 ture deaths, which  are  daily occafioned by  intemperanes, they
 would flirinkback with horror from the indulgence of their darling
 pleafures.
   Intemperance does not hurt its votaries alone: The innocent too
 often feel the effeas of it. How many wretched orphans are to be
 feen embracing dunghills, whofe parents, regardlefs Of the  future,
 fpent in riot and debauch  what  might have  ferved to bring up
 their oifspring in a decent manner ? How often do we behold the
 mother, with her infants, pining in want, while the cruel father is
 indulging his infatiate appetites ?
   Families are not only reduced to mifery,  but even extirpated by
 intemperance. Nothing tends fo much to prevent propagation, and
 '.">  fliorten the  lives of children, as the intemperance  of parents.
 The poor man who labours all day,'and at night lies down conten-
 ted  with his humble fare, can boaft a numerous offspring, while
 his pampered lord, funk in eafe and luxury,  often languifhes with-
 out  an heir to his ample fortunes. Even flates and empires feel the
 influence of intemperance, and rife or fall as it prevails.
   Inftead of mentioning  the different kinds of intemperance, and
 pointing out their influence upon health, we fhall only, by  way of
 example, make  a few obfervations on one particular fpecits of that
 vice, v.*. the abufe of intoxicating liquors.
   Every aa of  intoxication puts Nature to the expenfe of a fever,
 in order'to difeharge the  poifonous draught. When this is repeat-
 ed almoft every day, it is eafy toforefee the confequences. That
conftitution muft be  ftrong indeed, which  is  able long to hold
out under a daily fever !  but fevers occafioned by drinking do not
 always go off in a day: They frequently end in an inflammation of
 the breaft,  liver, or brain, and produce fatal effeas.
   Though the drunkard  fhould not  fall by an acute difeafe, he
feldom efeapes thofe of a chronic  kind. Intoxicating liquors, when.
ufed to excefs, weaken the bowels and fpoil the digeftion ; they
deftroy the power of the  nerves, and occafion  paralytic and con-
vulfive diforders. Hence obftruaions, atrophies, dropfies, and con-
iumptions of the lungs. Thefe  are the common ways  in  which
drunkards make their  exit.  Difeafes of this kind, when brought
on by hard  drinking, feldom admit  of a cure. 
                  OF INTEMPERANCE.             Si

  Many people injure their health by drinking, who feldom get
drunk. The habit of foaking, though its  effeas be not fo violent,
is not lefs pernicious. When the veffels are kept conftantly full and
upon the flretch, the different digeftions  can  neither be duly per-
formed, nor the humours properly prepared.  Hence, moft people
of this charaaer are affliaed with the gout, the gravel, ulcerous fores
in the legs, Sec. If thefe diforders do not appear, they are feized with
low fpirits, hypochondriacal affeaions, and other fymptoms of in-
digeftion.
  Confumptions arc now fo common, that it  is thought one-tenth
of the inhabitants of great towns die of that difeafe. Hard drinking
is no doubt one of the caufes to which we muft impute the increafe
of confumptions. The great quantities of vifcid malt liquor drank
by the common people of England, cannot fail to render the blood
iizy  and unfit for circulation j  from whence proceed obftruaions,
and inflammations of the lungs. There are few great ale-drinkers
who are not phthifical: nor is that to be wondered at, confidpring
the glutinous and almoft indigeftible nature of ftrong ale.
  Thofe who drink ardent fpirits or ftrong wines  run ftill greater
hazard ; thefe liquors heat and inflame the blood, and tear the
tender veffels of the lungs to pieces ; yet fo great is the confump-
tion of them in this country, that one would  almoft be induced to
think the inhabitants lived upon them*.
  The habit of drinking proceeds frequently from misfortunes  in
life*.  The miferable fly to it for relief.  It affords them indeed a
temporary eafe.  But, this folace is fhort-lived; and when it is over,
the fpirits fink as much below their ufual tone as they had before
been raifed above it. Hence, a repetition of the dofe becomes ne-
ceffary, and every  frefh dofe  makes way for another, till the urv-
happy wretch becomes a  flave to the bottle, and  at length falls a
facrifice to what at firft perhaps was taken only as a medicine.  No
man is fo dejeaed as  the drunkard when his debauch is gone off.
Thofe who have the greateft flow of fpirits while  the glafs circu-
lates freely, are of all others the moft melancholy when  fober, and
often put an end to their exiftence in a fit of fpleen or ill humour.
  Drunkennefs not only proves deftruaiveto health, but likewife
to the faculties of the mind. It is ftrange that creatures who value
themfelves on a fuperior degree of reafon to that of brutes, fhould
take pleafure in finking fo far below them. Were  fuch as volun-
 tarily deprive themfelves of the ufe of  reafon, to continue ever

  * We may form fome notion of the immenfe quantity of ardent fpi_
rits confumed in Britain from this circumftance,  that in the city of Edin„
burgh and its environs,  befides the great quantity of foreign fpirits duly
entered, and the ftill greater quantity which is fuppofed to be fmuggled^
it is computed that above twothoufand private ftills are conftantly eni-
ployed in preparing a poifonous liquor called molaffes. The commoa
people have got fo unlverfally into the habit of drinking this bafe fpirit,
that when a porter 6r labourer is feen reefing along the ftreets, they fay,
he has got molafflrd,
                               L 
&2
OF  CLEANLINESS.
&fter in that condition, it would feem but a juft punifhmenf.
Though this be not the confequence of one aa of intoxication, it   ^
feldom fails to fucceed a courfe of it. By a habit of drinking, the
greateft genius is often reduced to a mere idiot*.
   Intoxication is peculiarly hurtful to young  perfons. It heats   j
their blood, impairs their  ftrength, and obftruas their growth j
.befides, the frequent ufe of ftrong liquors in the  early part of life
deftroys any benefit that might arife from them afterwards.  Thefe
who make a praaice of  drinking generous liquors when young,
cannot expea to reap any benefit from them as a cordial in the.
decline of life.
   Drunkennefs is not only in itfelf a moft abominable  vice, but is
an inducement to many others- There is hardly any crime fo horrid
that the drunkard will not perpetrate for the love of liquor. We
have known mothers fell  their children's  clothes, the food that   '
they fhould have ate, and afterwards even the infants themfelves,
in order to purchafe the draught.
                CHAPTER   VIII.

                       Of Cleanlinefs.

      TYx'l want of cleanlinefs admits of no excufe.  Where water
      c:.n be had for  nothing, every perfon  can be clean.  The
continual difeharge from our bodies by perfpiration, renders fre-  '
quent change of apparel neceffary.  Changing apparel greatly pro-
motto the fecretion from the fkin,  fo neceffary for health. When
th?.t matter which ought to be carried off by perfpiration, is either
retained in the body, or reforbed from dirty clothes, it muft occa-
fion difeafes.
   Difeafes of the fkin are chiefly owing to want of clcanlinefsf.
They may indeed be caught by infeaion, or  brought on by poor

   3f It is amazing that improvements in am, learning, and politenefs,
have not put the barbarous cuftoin of drinking to excefs out of fafliion.
It is indeed lefs common in South Britain than it  was formerly ; but it
ftill prevails very much  in the  North, where this relic of barbarity i*
miftaken for hofpkality. There no man is fuppofed to  entertain his  ,
guefh well, Who does not make them drunk. Forcing people to drink,
is certainly the greateft piece of rudenefi that any man can be guilty of.
Manlinefs, compiaifance, or  mere good-nature  may induce a man to
tak'ihis glafs, if urged to it, at a time when he might as well take pcifbn.
The cuftom of drinking to excefs has long been out of fafliion in France;
and, as it begins to lofe graund among the politer part of the English,
we hope it will foon be banifhed from ev«ery part of this ifland.
  f Mr. PcJ, in his furgical obfervations, mentions a difeafe which he
calls the chhnuey-fueepers  cancej:, as it is almoft peculiar to that un-
happy i£>t of people. This he attributes to neglect, of cleanlinefs,  and
with great juftice. I am cohvinced, if that part of the body which is the
feat of this cruel difeafe  was kept clean by frequent walking, jt wouMt
never happen. 
                    .OF  CLEANLINESS.              83

Tiving, unwholefome food, &c. but they will feldom continue long
 where cleanlinefs prevails. To the fame caufe mud we impute the
 various kinds of vermin which infeft the human body, houfes, &c.
 Thefe may always be banifhed by cleanlinefs alone, and wherever
 thev abound, we have reafon to believe it is negfeaed.
   One common caufe of putrid and malignant fevers is the want
 of cleanlinefs. Thefe fevers  commonly begin among the inhabi-
 tants of clofe dirty houfes, who breathe unwholefome air, take lit-
 tle exercife, and wear dirty clothes. There the infeaion is gene-
 rally hatched, which often fpreadsfar and wide, to the deftruaion
 of many.  Hence cleanlinefs may be con fidcred as an objca of pub-,
 lie attention. It is not fufficient that I be clean  myfelf, while the
 want of it in my neighbour affeas my.health as well as his own.
 If dirty  people cannot be removed as a common nuifanee, they
 ought at leaft to be avoided as infeaious.  All who regard their '
 health fhould keep at a diftanoe even from their habitations.
   In places where great numbers  of people are coifeaed, cleanli-
 nefs becomes of the greateft importance. It is well known that in-
 feaious difeafes are communicated by tainted air.  Every thfec;,
 therefore, which tends to pollute the  air, or fpread the infeaion,
 ought with the utmofl ore to be guarded againft. For this reafo:":,
 in great towns, no filth of any kind, fhould be permitted to lie up-
 on the ftreets.  Nothing is more apt to convey infeaion than the
 excrements of the difeafed.           »
   In many great towns the ftreets are little better than dunghills,
 being frequently covered v/ith afhes, dung, and  naftinefs of every
 kind. Even flaughter-houfes, or  killing-fhambles are often to be
 feen in the very centre of great towns.  The putrid blood, excre-
 raeuts, &c. with which thefe places are generally covered, cannot
 fail tc t?.h:t.the air, and render it unwholefome.  How eafily might
 rliis be prevented by aaive magiftrates,  who have it  always in
' their power to make  proper laws relative to things of this nature,
 and to enforce the obfervance of them !
   We are forry,  that the importance of general cleanlinefs, does
 r.ot feem  to  be fufficiently une'erftood by the  magiftrates of moft
 great towns  in Britain ;  though health, pleafurc, and delicacy, ?M
 confpire to  recommend an attention to it.  Nothing can be more
 agreeable to the fenfes, more to the honour of the inhabitants, or
 more conducive to their health, than a clean town ; nor can any
 thing imprefs a ftranger with a more difrefpe&ful idea of any peo-
 ple, than  its oppofite. Whatever pretenfions people may make to
 learning, politenefs, or civilization, while they neg'eft cleanlinefs,
 they are in a ftate of barbarity*.

   #■ In ancient Rome the greateft men did not think cleanlinefs an
 object unworthy of their attention. Pliny fays, the? Cloacx, or  com-
 mon fewers, for the conveyance of filth and naftinefs from the city, were
 thegreateft of all the public works; and beftows higher encomium* up-
 on Tarquinius, Agrippa, and  others who made and improved, 'tlieai;
 than on thofe who atchieved the greateft conqvcAjs, 
84
OF  CLEANLINESS.
  The peafants in moft countries hold cleanlinefs in contempt.
Were  it not for the open fituation of their houfes, they would
often feel the bad effeas of this difpofition.  One feldom fees a
farm-houfe without a dunghill before the door, and frequently the
cattle and their mafters lodge under the fame roof.  Peafants are
likewife extremely carelefs with refpea to change of apparel, keep-
ing their houfes, &c. clean.  This is merely the effea of indolence
and a dirty difpofition. Habit may indeed render it lefs difagreea-
ble to them, but no habit can ever make it falutary to wear dirty
clothes or breathe unwholefome air.
   In camps, the ftriaeft regard fhould be paid to cleanlinefs. By
negligence in this matter,  infeaious difeafes are  often fpread
emongft a whole army; and frequently more die of thefe, than by
the fword.  The Jews during  their encampments in the wilder-
nefs, received particular inftruaions with refpea  to cleanlinefs*.
The rules enjoined them ought to be  obferved by all in the like
-fituation.  Indeed, the whole fyftem of laws delivered to that peo-
ple, has a manifeft tendency to promote  cleanlinefs.  Whoever
confiders the nature of their climate,  the difeafes to which they
were liable, and their dirty  difpofition, will fee  the propriety of
fuch laws.
   In moft eaftern countries, cleanlinefs makes a great part of their
religion.  The Mahometan,  as well as the Jewifh religion, enjoins
various bathings, wafhings,' and purifications. Thefe might be de-
signed to reprefent inward purity ; but they were at the fame time
calculated for the prefervation of health, However whimfical thefe
wafhings may appear to fome, few things would tend more to pre-
vent difeafes than a proper attention to many of them. Were eve-
ry perfon*, for example, after vifiting the fick, handling a dead bo-
dy, or touching any thing that might convey infeaion,-to wafh
before he went into company, or fat down to meat, he would run
lefs hazard either  of catching the infeaion himfelf, or of commu-
nicating it to others.
   Frequent wafhing not only removes the filth and fordes which
adhere to the fkin, but likewife promotes the perfpiration, braces
\the body, and enlivens the fpirits. How refrefhed, how cheerful,
Jind agreeable does one feel  on being fhaved, wafhed, and fhifted;
efpecially when thefe offices hrve been  negleaed longer than ufual!
   The eaftern cuftom of wafhing the feet, though lefs neceffary in
this country, is a  very agreeable piece of cleanlinefs, and contri*-
butes greatly to the prefervation of health.  The  fweat and  dirt
with which thefe parts are   frequently covered, cannot fail to ob-
ftrua the perfpiration. This piece of cleanlinefs would often pre-

   ■# " Thou flialttave a place alfo without the camp, whither thou fhalt
go forth abroad ; and thou fhalt have a paddle upon thy weapon : and
it fhall be when tho-a (halt eafe thyfelf abroad, thou fhalt dig therewith,
 and fhalt turn back, and cover that which cometh from thee, &c."Deuii,
 phap. xxiii. ver. 12, 13. 
                 OF CLEANLINESS.                85

vent colds and fevers.  Were people careful to bathe their feet and
legs in  lukewarm water  at night,  after being expofed to cold or
wet through the day, they would feldom experience the ill effeas
which often proceed from thefe caufes.
   A proper attention to cleanlinefs is no  where more  neceffary
than on  fhipboard.  If epidemical diftempers break out there, no
one can be fafc. The beft way to  prevent them, is to  take care
that the whole company be cleanly  in their clothes, bedding, &c.
When infeaious difeafes do break out, cleanlinefs is the moft like-
ly means to prevent their fpreading and to prevent their returning
afterwards, or being conveyed to other places. For this purpofe, the
clothes, bedding, &c. of the fick ought to be carefully wafhed, and
fumigated  with  brimftone.  Infeaion will  lodge a long time in
dirty  clothes, and afterwards break  out  in the moft terrible man-
ner.
   In  places where great numbers of fick people are  colfeaed to-
gether, cleanlinefs  ought to be moft  rcligioufly obferved.  The
very fmell in fuch places is often  fufficient to make one fick. It is
eafy to imagine what effea that  is  likely to have upon the difeaf-
ed. In an hofpital or infirmary,  where cleanlinefs is negfeaed, a
perfon in^perfea health has a greater chance to become fick, than
a fick perfon has to get welk
   Few things are more unaccountable than that neglea, or rather
dread of cleanlinefs, which  appears  among thofe who  have the
care of the fick ; they think it almoft criminal to fuffer any thing
that is clean  to  come near a perfon in a fever, for example, and
Would rather allow  him  to wallow in all manner of filth, than
change the leaft bit of his linen.  If cleanlinefs be neceffary  for
perfons in  health, it is certainly more fo for the fick. Many dif-
eafes may be cured by cleanlinefs alone : moft of them might be
mitigated by it; and, where it is negfeaed, the ffeihteft diforders
are often changed into the moft malignant. The  fame  miftaken
care which prompted people to prevent the leaft adiniffion of frefh
air to  the fick, feems to  have induced them  to keep them dirty.
Both  thefe deftruaive prejudices will, we hope, be foon entirely
eradicated.
   Cleanlinefs is agreeable to  our nature. We cannot help approv-
ing it in others, even though we praaife it not ourfelveS.  It fooner
attraas our regard  than even finery  itfelf, and often gains efteem
where that fails. It is an ornament to  the higheft as well as the
lowefl flation,  and cannot be difpenfecUwith in either.  Few vir-
tues are of more importance to fociety than general cleanlinefs.
It ought to be carefuily cultivated  every v/here j but in populous
cities, it fhould be almoft revered*.

   ■X- As it is impoflible to be throughly clean without a fuflicient quan-
tity of water, the magiftrates of great towns fliould be particularly at-
tentive to  this article.  Moft  great towns in Britain are fo fituated as
po be  eafily fupplied with water ; and thofe perfons who will not make 
[   86   ]
                 CHAPTER   IX.

                        Of Infcclion*

      MANY difeafes are infeaious. Every perfon ought, therefore,
       as far as he can, to avoid all communication with the difeaf-
      le common praaice of vifiting the fick, though  often well
meant, .has many ill confequences. We cannot help blaming fuch
as endanger  their own or their neighbours' lives by  a miftaken
fricndfhp or an impertinent curiofity.
  The houfes of the fick, efpecially  in the country, are generally
crowded from morning til! night with idle vifitors. It is cuftoma-    i
ry, in fuch places, for  fervants and young people to wait upon the
fick by turns, and even to fit up with them all night.  It would'be
a miracle indeed fhould fuch always cfcape. Experience teaches
us the danger of this condua.  People ouen catch fevers in this
way, and communicate them to others, till at length they become
epidemic.
  It would be thought highly improper, for one who  had, not had
the fmall-pox, to wait upon a patien*. in  that difeafe  ; yet many
other fevers are almoft as infectious as the fmall-pox,  and no: lefs
fatal.  Some imagine that fevers prove more fatal in villages than
in great towns, for want of proper  medical afliftnnce. This may
  metimes  be the  cafe ;  but we  think it oftener proceeds from
  e caufe above-mentioned.
   Were a plan to  be  laid down for  communicating infeaion, it
could  not be done more  effeaually than  by the common  method
of vifiting  the fick. Such vifitors not only endanger themfelves   j
and their conneaions, but likewife hurt the fick.  By crowding
the houfe, they render the air unwholefome, and by their private
whifpers and difmal countenances difturb the  imagination of the
patient, and  deprefs his  fpirits.  Perfons who are ill, efpecially in
fevers, ought to be kept  as quiet  as poffible. The fight of ftrange
faces, and every thing that difturbs  the mind, hurts them.
   The common practice in country places of inviting great num-
bers of people to funerals, and crowding them into the fame apart-   <j
ment  where the. corpfe lies, is another way of  fpreading in-
feaion.  The infeaion does not always die with the patient.  Eve-
ry thing that comes into  contaa with his body while alive, receive*
the contagion, and fome  of them, as clothes, blankets, ecc. will re-   -
tain it for a long time. • Perfons who die of infeaious diforders,

 a proper nfe of it, after it is brought to their hand, deferve to bepunifh-
 ed. ,The h:-c.tii- of great towns, where water can be had, ought  to be
 waflied every day.  This is the only effectual method for  keeping them
 thoroughly clean j and upon trial,  we are perfua-.led it  will  be fountj  ■ *1
 the cheapeft. 
OF  INFECTION.                  %7
 ought not to lie long unburied ;  and people fhould keep as much
 as poffiblb at a diftance from them.
    It would tend greatly to prevent the fpreading of infeaious dif-
 eafes, if thofe in  health were kept at a proper diftance  from the
 fick.  The Jewifh legiflator,  among many other wife inftitutions
 for preferving health, has been peculiarly attentive  to the means
 of preventing infeaion, or defilement as  it is called, either from a
 difeafed perfon or a dead body.  In many cafes  the difeafed were
 to be feparated  from thofe in health ; and it was deemed a crime'
 even to approach their  habitations.  If a perfon only touched a
 difeafed or dead body, he was appointed to wafh himfelf in water,
 and to keep for fome time at a diftance from fociety.
    Infeaious difeafes are often communicated by clothes. It is ex-
 tremely dangerous to wear apparel which has been  worn by the
 deceafed,  unlefs it has been  well wafhed  and fumigated, as infec-
 tion may lodge  a Ion? time in it, and afterwards produce very tra-
 gical effeas. This fhows the danger  of buying at random the
 clothes which have been worn by othsr peopfe.
    Infeaious diforders are frequently imported.  Commerce, toge-
 ther with the riches of foreign climes, brings their difeafes.  Thefe
 do often more than counterbalance ail the advantages of that trade
 by means of which they are  introduced. It is to be regretted, that
 fo little care is  commonly bellowed, either to prevent  the intro-
 duaion or fpreading of infeaious maladies.  Same attention in-
 deed is  generally paid to the plague ; but other difeafes'pafs un-
 regarded*.
    Infeaion is often fpread through cities, by jails, hofpitals, &c.
 Thefe are frequently fituated in the very middle of populous townsj
 and when infeaious difeafes  break out in them, it is impoflible for
 the inhabitants to efcape. Did magiftrates pay any regard to the
 health of the people, this evil might be eafily remedied.
    Many are the caufes  which tend  to diffufe infeaion through
 populous cities.  The whole atmofphere of a large town is one con-
 taminated mafs, abounding with various  kinds of infeaion, and
 muft be pernicious to health. Such as are obliged to live in large
 cities, ought to  choofe an open fituation ; to avoid narrow, dirty,


   ■jf- Were the tenth part of the care taken to prevent the importation
 of difeafes, that there is to preventfmuggling, it would be attended wiU?
 many happy confequences. This might eafily be done by appointing a
 phyfician at every confiderable  fea-port, to inf >ecl the (hip's company,
 paflengers,  &c. before they 'came afhorc, and, if; riy fever or other in-
 feaious diforder prevailed, to order the fiiip to perform a Ihort quaran-
 tine, and to fend the fick to fomehofpital or  proper place to be cured.
 He might likewife order all the clothes, bedding, &c. which had beea
 ufed by the lick during tne voyage, to be either deilroyed, or thoroughly
 cleanfedby fumigation, &c. before any of it wtrefent afhore.  A fcheme
 of this kind,  if properly conduced, would prevent many fevers, and
"other infectious difeafes, from being brought by failors into fea-poi'
 towns, and by this means diffufed alt over the country. 
88                  OF INFECTION.

crowded ftreets; to keep their own houfes and offices  clean ; and
to be as much abroad in the open air as their time will permit.
   It would tend greatly to prevent the fpreading of infeaious dif-    1
eafes, were proper nurfes every-where employed to take care of the
fick. This might often fave a family, or even a whole town, from
being  infeaed by one perfon.  Not that people fliould abandon
their  friends or relations  in diftrefs, but only be on their guard
againft being too much in company with thofe who are affliaed
with difeafes of an infeaious nature.
   Such as wait upon the fick in infeaious difeafes  run very great
hazard. They fhould fluff their nofes with tobacco; or fome other
ftrong fmelling herb, as rue, tanfy, or the like. They ought like-
wife to keep the patient very clean, to fprinkle  the room where
he lies with vinegar, or other ftrong  acids,  frequently to admit a
Ilream of frefh air into it, and to  avoid the fmell of his breath as .
much as they can. They ought never to go into company without
having changed  their clothes and  wafhed their hands ;  otherwife,
if the  difeafe be infeaious, they  will in  all probability carry the  ,'M
contagion along with them*.                                   v "
   A due attention to thofe things which  tend to diffufe infeaion
would be of great importance in preventing difeafes. As moft dif- ,  ]
eafes are in  fome degree infeaious, no one fhould continue long   j
with the fick, except the neceffary attendants. I  mean not howe-
ver, by this  caution, to deter thofe whofe duty or office leads them
to wait upon the fick, from fuch a laudable and neceffary employ-
ment.
   Many things are in the power  of the magiftrate which would   ]
tend to prevent  the fpreading of infeaion  j as the promoting of
public cleanlinefs; removing jails, hofpitals, burying grounds, and
other places  where infeaion may be  generated, at a  proper  dif-
tance from  great  towns-)-; widening the  ftreets ; pulling down
ufelefs walls, and taking all methods to promote  a free circulation
of air through  every part of the  town, &c. Public  hofpitals, or
proper places of reception for the fick, provided  they were kept
clean, well ventilated, and placed in aa open fituation, would like-
wife  tend to prevent the  fpreading of infeaion.  Such places of


   * There is reafon to believe that infection is often conveyed from
one place to another by tlu carelelfiiefs of the faculty themfel \ e ;. Many
 })hyficians affect a familiar way of fitting upen the patient's bedfide, and
 lolding his arm for a confiderable time. If the patient has the fmall-pox,
or any other infectious difeafe, there is no doubt but  the doftor's hands,
tiothes, &c.will  carry away fome of the infection;  and, if he  goes di-
rectly to vifit another patient without wafhing his hands,  changing his-   (
clothes, or being  expofed to  the open air, which is'not feldom the cafe,   i
is it any wonder that he fliould carry the difeafe along  with him ? Phy-
ficians not only endanger others, but alfo themfelves,  by this practice.
And indeed they fometimes fuffer for their want of care.                '
   t The ancients  would not fuffer even the temples of their rods where.
the fick reforted,  to be built within the walls of a city.                 * 
                 OF  THE PASStONS.              ,8$,

reception would prevent the poor, when fick, from being vifited
by their idle or officious neighbours.  They would likewife render
it unneceffary  for fick fervants to be kept in their mailers houfes.
Mailers had better pay for having their fervants taken care of in an
hofpital, than run the hazard of having an infeaious difeafe diffu-
fed among a numerous family.  Sick fervants  and  poor  people,
when placed in hofpitals, are not only lefs apt to diffufe infec-
tion among their neighbours, but have likewife the advantage o£
being well -attended.
   We are not, however, to- learn that hofpitals, inftead of pre-
venting infeaion, may become the means of di/fufing it.  When
 they are placed in the middle of great towns ; when numbers of
 patients are crowded together into fmall apartments; when there
 is a conftant communication kept up between the citizens and the
 patiants; and when cleanlinefs and ventilation are negfeaed, they
 become nefts  for hatching difeafes,  and every one who goes into
 them, not only runs a rifk of receiving infeaion himfelf, but like-
 wife of communicating it to others. This is not the fault of hof-
 pitals, but of thofe  who have the management of them. It were
 to be wifhed, that  they were both more numerous,  and upon a
v more refpeaable footing,  as that would induce people to go into
 them with lefs reluaance.  1 his is the more to be defired, becaufe
 moft of the putrid fevers and other infeaious diforders break out,
 among the  poor, and are by  them  communicated to the better
 fort.  Were proper attention paid to the firft appearances of fuch
 diforders, and the patients early conveyed to an hofpital, we fhould
 feldom fee a putrid fever,  which  is  almoft as infeaious as the
 plague, become epidemic.
                  CHAPTER   X.

                      Of the Pajjiorts.

    THE paflions have great influence both in  the caufe and cure
     of difeafes. How the mind affeas the body, will, in all proba-
bility ever remain a fecret. It is fufficient for us to know, that there
is eftablifhed reciprocal influence between the mental and corpo-
real parts, and that whatever injures the one, diforders the other.
                           Of Anger'.

     THE paflion of anger ruffles the mind, diftorts the countenance,
   hurries on the circulation of the blood, and diforders the whole
   vital and  animal funaions.   It often occafions fevers, and other
^.  acute difeafes ; and  fometimes even fudden death.  This paffion
                              M 
 $o               OF THE PASSIONS.

 is peculiarly hurtful  to the delicate,  ?nd thofe of weak nerves.
 Such pcrfont frequently lofe their lives by a violent fit  of anger,
 and  I would advife them to guard againft the excefs of this paffion
 with the utmoft care.
   It is not indeed always in  our power to  prevent being angry ;
 but we may furely avoid harbouring refentment in our breaft. Rt-
 fentment preys upon the mind, and occafions the moft obftinate  '
 chronical diforders which gradually wafle^ the conftitution. Nothing
 fliows true greatnefs  of mind more than to forgive  injuries; it
 promotes  the peace of fociety, and  greatly conduces  to our own
 eafe, health, and felicity.
   Such as value health fliould avoid violent gufts of anger, as they
 would the moft deadly poifon. Neither ought they to indulge re-
 fentment, but to endeavour at all  times to keep their minds calm1
 and ferene. Nothing tends fo much to  the health of the body as a
 conftant tranquillity of mind.



                          Of Fear.

   THE influence pf  fear, both in  occafioning and aggravating
 difeafes, is very great.  No man ought to be blamed for a decent
 concern about life; but too great a defire to preferve it is often
 the caufe of lofing it. Fear and anxiety, by depreffing the fpirits,
 not-only difpofe us to difeafes, but often render thofe difeafes fatal
 which an  undaunted mind would overcome.
   Sudden fear has generally  violent  effeas.  Epileptic fits, and
 other convulfive diforders, are often  occafioned by it.  Hence the
 danger of that praaice, fo common  among young people, of
 frightening one another.   Many  have  loft  their  lives, and others
have been rendered miferable, by  frolics of this kind.  It is dange-
rous to-tamper with the human paffions.  The mind may eafdy be
 thrown into  fuch diforder as never again  to aa with regularity.
   But the gradual effeas of fear prove more  hurtful. The con-
ilant dread of fome future evil, by dwelling upon the mind, often
occafions the very evil itfelf.  Hence it  comes to pafs, that fo many
die of thofe very difeafes of which they long had a diead, or which *
had  been impreffed  on their minds  by forhe accident, or foolifh  ,
prediaicn.  This, for example, is often the cafe with women in
child-bed. Many of thofe who die in that fituation are impreffed
with the notion of their death a long time before it happens ; and
there is reafon to believe that this impreffion is  often the caufe  '•
of it.
 ■ The methods taken  to imprefs the minds of women with ap-
prehenfions of  the great pain  a,nd peril  of child-birth, are very
hurtful.  Few women die in labour,  though many lofe their lives
after it; which may be thus accounted  for.   A woman after deli- ■: 
                 OF THE PASSIONS.                gi

very, finding hcrfelf weak and exhaufted, immed'iatelv apprehends
fhe is in danger ; but this fear feldom fails to obftrua the neceffa-
ry evacuations, upon which her recovery depends.  Thus, the fex
often fall a facrificeto their own i mi filiations, when there would
be no danger, did they apprehend none.
   It feldom happens that two or three  women in a  gre!it town die
in child-bed, hut their death is followed by many others. Every
woman of  their acquaintance who is with  child drfcads the fame
fate, and the difeafe becomes epidemical by the mere force of ima-
gination. This fhould induce pregnant women to defp^fe fear, and
by all means to avoid  thofe tattling goflips who are continually
buzzing in their ears the misfortunes of others.  Every thing that
may in the  leaft alum a pregnant or child-bed woman, ought with
the greateft care to be guarded againft.
   Many women have loft  their lives in  child-bed by the old fu-
perftitious  cuftom, ftill kept up-inmofl parts of Britain, of tolling
the parifhbell for every perfon  who dies'. People who think them-
felves  in danger are very inquifitive ;  and if they come to know
that the bell  tolls  for one who died in the  fame  fituation with
themfelves, what muft be the confequence  ?  At any rate they are
apt to fuppofe that this is the cafe, and  it wilLoften  be found a dif-
ficult matter to perfuade them of the contra!^.                 y
   But this cuftom is not pernicious to child-bed women only.  It
is hurtful in ma»y other cafes. When low fevere, in which it is
difficult to fupport the patient's fpirits, prevail, what muft be the
effea of a funeral peal founding five or fix times a day in his ears?
No doubt his imagination  will  fugged that others died of the dif-
eafe under which he labours. This apprehenfion will have a great-
er tendency to deprefs his  fpirits, than all the cordials of medicine
will have to raife them.
   If we have not fenfe enough  to abolifli this ufelefs piece of cere-
mony, we ought to keep the fick zc, much from hearing it as poffible,
 and from every other thing that may tend to alarm them.  So fav
 however is this from being generally attended to, that many make
it their bufinefs to vifit the fick, on purpofe to whifper difmal fto-
ries in their ears. Such may pafs for fympathizing friends, but they
 are their enemies.  All who wifh well  to  the fick ought to keep
fuch perfons at the greateft  diftance from them.
   A cuftom has  long prevailed among phyficians, of prognofti-
cating, or  foretelling the  iffue of the difeafe. Vanity introduced
 this praaice, and ftill fupports it, in fpite of common fenfe and
 the fafety of mankind. I have known a phyfician barbarous enough
 to boaft, that he pronounced more fentences than all his Majefty's
 judges. Would to God that fuch fentences were not often equal-
 ly fatal!  It may indeed  be alleged, that the doaor does not de-
 clare his opinion before the patient. So much the worfe. A fenfi-
 ble  patient had better hear what the doaor fays, than learn it from
 the difconfolate looks, the watery eyes, and the broken, whifpers 
Q2               OF THE  PASSIONS.

of thofe about him. It feldom happens, when the doaor gives an
unfavourable opinion, that it can be concealed from the patient.
The very embarraffment which the friends and attendants fhow in
difguifing what he has faid, is generally fufficient to difcover the
truth.
   Heaven has concealed from mortals  their fate ;  and we do not
fee what right any man has to announce the death of another, ef-
pecially if fuch a declaration has a  chance to kill him. Mankind
are indeed very fond of prying into  future events, and feldom fail
to folicit the phyfician for his opinion.  A doubtful anfwer, cr one
that may tend rather to encourage the  hopes of the fick, is furely
the moft fafe. This condua could neither hurt the patient nor the
phyfician. Nothing tends more to deftroy the credit of phyfie than
thofe bold prognofticators, who by the  bye, are generally the moft  ,
ignorant of the faculty. The miftakes  which daily happen in this
way are fo many ftanding proofs of human vanity, and the weak-
nefs of fcience.
   There are cafes where the phyfician  ought to give intimation of  "
the patient's danger to fome of his near conneaions -/though even  $
this ought always to be done with the greateft caution : but it ne-
ver can be neceffary in  any cafe that the whole town  and country
fhould know, immediately after the doaor has made his firft vifit,
that he has no hopes of his patient's recovery. Perfons whofe im-
pertinent curiofity leads them to queftion the phyfician with regard  \
to the fate of his patient, deferve no anfwer.
   The vanity of foretelling the fate of the fick is not peculiar to
the faculty.   Others  follow their example, and thofe who think
themfelves wifer than their neighbours often do much hurt in this
way. Humanity furely calls upon every one to comfort the fick,
and not to add to their affliaion by  alarming their fears.  A friend,   .
or even a phyfician, may often do more good by a mild and fym-
pathizing behaviour than by medicine, and fhould never negleft
to adminifter that greateft'of all cordials, Hope.
                         Of Grief.

  GRIEF is the moft deftruaive of all the paffions. Its effeas are  »
permanent, and when  it finks  deep into the mind,  it generally
proves fatal. Anger and fear, being of a more violent nature, fel-  •
dom laft long;  but grief  often changes into a fixed melancholy,
which preys upon the fpirits, and waftes the conftitution.  This
paflion ought not to be indulged. It  may generally be conqueieil
at the beginning; but when it has gained ftrength, all attempts to
remove it are vain.
  No perfon  can prevent  misfortunes in life ;  but it  fhows true
greataefs of mind to bear them with ferenity. Many perfons make 
OF  THE PASSIONS.
93
a merit of  indulging grief, and when misfortunes happen, they
obftinately refufe all confolation, till the mind, overwhelmed with
melancholy, finks under the load.  Such condua  is not only de-
ftruaive to health, but inconfiftent with reafon, religion, and com-
mon fenfe.
  Change of ideas is as neceffary for health as change of pofture.
When the mind dwells long upon one fubjea, efpecially of a dif-
agreeable nature, it hurts the whole funaions of the body. Grief
indulged fpoils the digeftion and deftroys the appetite ; hence the
fpirits are depreffed, the nerves relaxed, the bowels inflated with
wind, and the humours, for want of frefh fupplies of chyle, vitia-
ted.  Many an excellent conftitution has been ruined by a  family-
misfortune, or any thing that occafions exceffive grief.
  It is utterly impoflible, that any perfon of a  dejeaed mind
fhould enjoy health.   Life may indeed be dragged out  for a few
years : but whoever would live to a good old age, muft be good-
humoured and cheerful.  This indeed is  not  altogether in our
own power ; yet our temper of mind, as well as our aaions, de-
pends greatly upon ourfelves. We can either aifociate with cheer-
ful or melancholy companions, mingle in the amufements and
offices of life,'or fit ftill and brood over our calamities as we choofe.
Thefe, and many fuch things, are certainly in our power, and from
thefe the mind generally takes its  call.
   The variety of feenes which prefent themfelves to the fenfes,
were certainly defigned to  prevent our attention  from being too
long fixed  upon any one object.  Nature abounds with  variety,
and the mind, unlefs fixed down by habit, delights in contempla-
ting new objeas.  This at once points out the method of reliev-
ing the mind in  diftrefs.   Turn the attention frequently  to new
objeas.  Examine them for fome  time.  When the mind begins
to recoil, fhift the fcene.  By this  means, a conflant fucceflion of
new ideas may be kept up, till the difagreeable ones entirely difap-
pear.  Thus travelling, the ftudy of any art  or fcience,  reading
or writing on fuch fubjeas as deeply  engage the attention, will
fooner expel grief than the moft fprightly amufements.
  As the body cannot  be heakhly unlefs it be exercifed;  neither
can the mind. Indolence nourifhes grief. When the mind  ha9 no-
thing elfe to think of but calamities, no wonder that it dwelV there.
Few people who purfue bufinefs with attention are hurt by grief.
Jnftend therefore  of abftraaing ourfelves from the world  or bufi-
nefs, when misfortunes happen, we ought to engage in  it with
more than ufual attention,  to  difeharge with double diligence the
funaions  of our  flation, and to  mix with friends  of a cheerful
and fecial temper.
  Innocent amufements are not to be negfeaed.  Thefe, by lead-
ing the mind infenfibly to the contemplation of agreeable objeas,
help to  difpel the gloom which misfortunes call'over it.  They
make time feem lefs tedious, and have many  other happy effea.'. 
94               OF  THE  PASSIONS.

   Some perfons, when overwhelmed with grief, betake themfelves
to drinking.  This is making the cure worfe than the difeafe.  It
feldom fails to end in the  ruin of fortune, charaaer, and confti-
tution.
                          Of Love.

'" LOVE is perhaps the ftrongeft of all the paffions; at leaft, when
it becomes violent,  it is lefs fubjea  to the controul either of the
underftanding or will, than any of the reft. Fcaf, anger, and feve-
ral other pailions are neceffary for the prefervation of the indivU
dual, but love is neceffary for the continuation of the fpecies itfelf: ,
It was therefore proper that this pafiion fliould be deeply rcoted in .'
the human breaft.
  Though love be a ftrong paffion, it is feldom fo rapid in its pro-
 grefs as feveral of the others.  Few perfons fall defperately in love
 all-at-once. Y/e would therefore advife every one, before he tam-
 pers with  this paffion, to confider well the probability of his being
 able to obtain the objea of his love.  When that is not likely, he
 fhould avoid every occafion of  increafing it. He ought immediate-'
 ly to fly  the company of the  beloved objea ; to apply his mind
 attentively to: bufinefs or ftudy; to take every kind of amufement;
 and above all, to endeavour, if poffible, to find another objea which
 may engage his affe£lions, and which it may be in his power to
 obtain.
   There is no paffion with which p:opleis fo ready to tamper as love,
 although none is more dangerous. Some men make love for amufe-  '
 ment, others from mere vanity, or on purpofe to fhow their confe-
 rence  with  the fair. This is perhaps the greateft piece of cruel-
 ty, which  any one can be guilty of.  What we eagerly wifh for we
 eafily credit. Hence, the too credulous fair are often betrayed into
 a fituation wich is truly deplorable, before they are able to difcoyer
 that the pretended lover was  only in j eft.  But there is no jelling
 with this paffion. When love haN got to a  certain height, it admits
 of no other cure but the pofleffion of its objea,  which in this cafe
 ought always if poffible to be obtained'.           x


   ■fc  The conduct oT parents with regard to the difpofal of their chil;
 dren in marriage is often very blameable. An advantageous matchis the
 conftant aim of parents ; while their  children often fuffer a real mar-
 tyrdom betwixt their inclinations and duty.  The firll thing which pa-
 rents ought to confult in difpofing of their children in marriage, is cer- j
 tainly their inclinations.  Were due regard  always paid to thefe, thers'
 would be fewer unhappy couples, and parents would not have fo often
 caufe to repent the feverity of their conduft, after a ruined confUtutioB,
 a loit  character, or a difixacrcd  mind,  ha; fnown them their iniftake. 
                         [  9£_ 1       '
            <.               -            ^
 /                       t
                 Of Religious  Melancholy.

  MANY perfons of a religious turn of mind  behave  as if they
thought it a crime to be cheerful.  They imagine the whole of re-
ligion confifts in certain mortifications, or denying themfelves the
fmalleft indulgence, even  of the moft innocent amufements. A
perpetual gloom hangs over their countenances, while the deepeft
melancholy preys upon their minds. At length the faireft profpeas
vanifli,  every thing puts on a difmal  appearance, and thofe very
objeas which ought to give delight,  afford nothing but difguft.
Life itfelf becomes a burden, and the  unhappy wretch,  perfuaded
that no evil can equal what he fe^ls, often puts an end to his own
exiftence.
  Perfons whofe  bufinefs  it is to  recommend religion  to others,
fhould beware of  dwelling too much on gloomy fubjeas.  That
peace and tranquillity of mind, which  true religion is calculated to
infpire, is a more powerful  argument in its favour, than all the ter-
rors that can be uttered. Terror may indeed deter men  from out-
ward aas of wickednefs, but can never infpire them with that love
of. God, and real goodnefs  .of heart, in which alone true religion
confifts.                                   -
  The beft way to  counteraa the violence of any paffion, is to
keep the mind clofely engaged in fome ufeful purfuit.
                 CHAPTER   XI.

               Of the Common Evacuations.

     TilE principal evacuations from ths human body are'thofe by
      flool, urine and infenfible perfpiration.  None of thefe can
be long obllruaed without impairing health.  When that which
ought to be thrown Out of the body is too long retained,  it occa-
fions a plethora, or too great fumefe of the veffels.
                Of the  Evacuation  by Stool.

  FEW things conduce more to health than keeping the body re-
gular.  When the fosces lie too long in  the boweds, they vitiate the
humours ; and when they are too foon  difcharged, the body is not
fu.ficiently nourifhed. A medium is to  be defired, which can only
be obtained by regularity in diet, fleep and exercife.  Whenever the
body is not regular, there is reafon to fufpea a fault in one or other
of thefe.
   Perfons  who eat and drink at irregular hours, and who cat vari- 
96       OF THE  COMMON EVACUATIONS.

nus kinds of food, and drink of feveral different liquors  at every
meal, have no reafon to expea either that their digeftion will be
good, cr their difeharges regular.  Irregularity in eating and drink-
ing, difturbs every part of the animal ceconomy,  and  never fails
to occafion difeafes.  Either too much or too little food will have
this effea.  The former indeed generally  occafions loofenefs, and
the hitter coftivenefs ; but both have a tendency to hurt the health.
  It wouldbe difficult to afeertain the exaa number of flools which   ,
 may be confiflent with health, as thefe differ in the different pe-   !
riods of life,  in different conftitutions, and even in the fame con-
ftitution under a different regimen of diet, exercife, &c. It is how-
ever generally allowed,  that one flool  a-day is fufficient for an
adult, and that lefs is hurtful.  But this,  like  moft general rules,
admits of many exceptions. I have known perfons in perfea health   '
who did not go to flool above once a-weck. Such a degree of cof-
tivenefs is not fafe ;  though the perfon who labours under it may
for fome time enjoy tolerable health, yet at length it may occafion   :
 difeafes.
   One method of procuring a ftool every day is to rife betimes, and
 go abroad in the open air.  Not only the pofture in bed is unfavour-
 able to regular flools, but alfo the warmth.  I his, by promoting
 the perfpiration, leffens all the other difcharges.
   The method recommended for this  purpofe by Mr.  Locke, is
 likewife very proper, viz.  to folicit Nature, by going regularly to
 flool, every morning whether one has a call or not.  Habits of this
 kind may be acquired, which will in time become natural.
   Perfons who have frequent recourfe to medicines for preventing   '
 coftivenefs, feldom fail to ruip their conftitutions. Purging medi-  ■•■
 cines frequently repeated, weaken the bowels,, hurt the  digeftion,
 and every dofe makes  way for another, till at length they become
 as neceffary as daily bread. Thofe who are troubled with coftive-
 nefs, ought  rather,  if poffible, to remove it  by diet than drugs.  |
 They fhould go thinly clothed, and avoid every thing  of an aftrin-
 gent or heating  nature.  The diet and other regimen neceffary
 in this cafe, will be found under the article CoJlivenefsy where this
 ftate of the bowels is treated as a difeafe.
    Such perfons as are troubled with  a  habitual loofenefs  ought
 likewife to fuit their diet to the nature  of their complaint. They
 fhould ufe food which braces  and flrengthens  the  bowels, and
 which is rather of an aftringent quality, as wheat-bread made of
 the fineft flour,  cheefe,  eggs, jice boiled in milk,  &c.  Their
  drink  fhould be red-port, claret, brandy and water,  in  which
  toafted bread has been boiled, and fuch like.
    As an habitual loofenefs is oftejn owing to an obflruaed perfpi-
  ration, perfons affeaed with it ought to keep their feet warm, to
  wear flannel next their fkin,  and take every other method to pro-
  mote the perfpiration.   Further direaions,  with regard to the
  treatment of this complaint, will be found under the article Loofenefs* ■ 
L   97   ]
                          Of Urine.

   SO many things tend to change both the quantity and appear-
 ances of the urine, that it is very difficult to lay down any deter-
 mined rules for judging of  either*.  Dr. Cheyne fays, the urine
 ought to be equal to three-fourths of the liquid part of our aliment.
 But fuppofe anyone were to take the trouble  of  meafuring both,
 he would find, that every thing which altered the degree of per-
 fpiration, would alter this proportion, and likewife,  that different
 kinds of aliment would afford very different  quantities of  urine.
 For thefe,  and other reafons,  no rule can be given for judging of
 the precife quantity  of urine which ought to be difcharged, yet a
 perfon of common fenfe will feldom be at a lofs to know when it
 is in either extreme.
    As a free difeharge of urine not only prevents, but aaually cures,
 many difeafes,  it ought, by all means, to be promoted ; and every'
 thing that may  obftrua it fhould be carefully avoided.  Both the
 fecretion and difeharge of urine are leffened by a fedentary life,
 fleeping on beds that arc too foft and warm, food of  a  dry and
 heating quality, liquors which are aftringent and heating, as red-
 port, claret, and  fuch like.   Thofe who fufpea that their urine
 is in too fmall quantity, or who have any fymptoms of the gravel,
 ought to avoid  thefe things, and whatever elfe has a tendency to
 leffen the quantity of their urine.
    When the urine  is too long retained, it is not only re'-abforbed
  or taken up again into the mafs of  fluids, but,  by ftagnating in
 the bladder, it becomes thicker, the more watry parts flying  off
  firft, and  the  more grofs and earthy remaining behind.   By the
  conflant tendency which thefe have to  concrete, the formation of
  ftones and gravel in the bladder is  promoted.   Hence, indolent
  and fedentary people are much more liable to thefe difeafes, than
  perfons of a more aaive1 life.

     #■ It has long been  an obfervation among phyficians, that the ap-
  pearances of the urine are very uncertain, and very little to be depen„
  rled on.  No one  will  be furprifed at this, who confidershow many ways
* it may be affected,  and^confequently have its appearance altered. The
  naflions, the  ftate  of the atmofphere, the quantity and quality of the
  food the exercife, the clothing, the ftate of the other evacuations, and
  numberlefs other caufes, are fufficient to induce a change either in the
  quantity or appearance of the urine. Any one who attends to this, will
  be aftonimed at  the impudence of thofe daring quacks, who pretend to
  find out difeafes, and  prefcribe topatients from the bare infpeftion of their
  urine.  Thefe .impoftors; however, are very common all over Britain,
  and by the amazing credulity of the populace, many of them amafscon-
  fideruble fortunes. Of all the medical prejudices which prevail in this
  country, that in favour of urine-doftors is the ftrongeft. The common
  people have ftill an unlimited faith in their fkill,  although it has been
  clemoniirated that no one of them is able to diftiDguifh the urine el a
  horfe,  or  any other  animal, from that ©f a man.
                 f              N 
oS       OF THE COMMON EVACUATIONS,

  Many perfons have loft their lives, and others have brought on
very tedious, and even incurable diforders, by retaining their urine
tpo long, from a falfe delicacy. When the bladder has been over-
diftended, it often loofes its  power of aaion altogether, or be-
comes paralytic, and is rendered unable either to retain th«j urine,
or expel it properiy.  The calls of nature ought never to be poft-
poned.  Delicacy is a virtue ; but that can  never be reckoned
true delicacy, which induces  anyone to riik his health or hazard
his life.
  Urine  may be in tod great as well as too fmall  a quantity, by
drinking large quantities of weak watery liquors,- by the exceffive
ufe of alkaline falts, or any thing that flimulates the kidnies,  di-
lutes the blood,  Sec.  This diforder very foon weakens the body,
and induces a confumption.   It  is difficult to cure, but  may be
mitigated by ftrenghtening diet and aftringent medicines, fuch arc
recommended under the article Diabetes.



                   Of the  Perfpiration.

  INSENSIBLE perfpiration is generally reckoned the greateft of
all the discharges from  the human body.  It is of fo great irnpor-
•ance to health, that few difeafes attack us while it goes properly
on; but when it is obftruaed, the.whole frame is fcondifordered*
This difeharge, however, being lef9 perceptible than  any of the
reft, is confequently lefs attended to.  Hence, acute fevers, rheu-
matifms,  agues, Sec.  often proceed  from obftruaed perfpiration
hefore we are aware of its having taken place.
  On examining patients, we find moft of them   impute their
difeafes either to violent colds which they had caught,  or to flight
ones which had been negfeaed.  For this  reafon,  inftead  of a
critical inquiry into the nature of the perfpiration, its difference
in different feafons, climates,  conftitutions,  Sec. we fhall endea-
vour to point out the caufes which moft commonly  obftrua it,
and to fhow how far they may be either avoided,  or  have their
influence counteraaed by timely care.  The want of a due at-
tention to thefe, cofts Britain annually fome thoufands of ufeful
lives.
                Changes in  the  Atmofphere.

  ONE of the moft common caufes of obftruaed perfpiration, cr
catching cold,  in this country, is the changeablenefs of the wea-
ther, or ftateof  the atmofphere.  There is no place where fuch
changes happen more frequently than in Britain.   With us, the
degrees of heat and cold are not only very different in the differ* 
OF  THE  COMMON  EVACUATIONS.
cnt feafons of the year, but often change almoft from one extreme
to another in a few days, and fometimes even in the courfe of one
day.  That fuch changes muft affea tlu ftate of  the perfpiration
is obvious to every one*.
   The beft method of fortifying the body againft the changes of
the weather, is  to be abroad every dav.  Thofe who keep moll
within doors are moft liable to catch cold- Such perfons generally
render themfelves fo delicate as to feel even the flighted chanee.-;
in the atmofphere, and by their pains,  coughs, and oppreffions of
-he breaft, o.c. they become a kind of  living barometers.
                        Wet Clothes.

  WET clothes not only by their coldnefsobftrua the perfpiration,
but their moiflure, by being  abforbed, or taken up into the body,
greatly increafes  the danger.  The moft robuft conftitution is not
proof againft the danger ariGng from wet clothes ; they daily oc-
cafion fevers, rheumatifms, and other fatal diforders, even  in the
young and healty,       ;
  It is impoflible for people who go frequently abroad, to avoid
fometimes being  wet.  But the danger might generally be leflcned,
if not wholly prevented, by changing their  clothes foon ;  when
this cannot be done, they fhould keep in motion till they be dry.
So far are many from taking  this precaution, that they often lit
or lie down in the fields with their  clothes  wtt,  and frequently
fleep even whole nights in this condition.  The frequent inftances,
which we have of the fatal effeas of  this condua, ought to deter
others from being guilty of it.
                          Wet Feet.

   EVEN wet feet often- occafion fatal difeafes. The cholu:, inflam-
mations of the breaft and of the bowels, the iliac paffion, chofera
morbus, &c.  are  often occafioned by wet feet. Habit will render
this lefs dangerous; but it ought, as far as poffible, to be avoided.
The delicate,  and thofe  who are  not accuftomed to have their
clothes or feet wet, fliould be peculiarly careful in this refpea.

  ■X-  I never knew a more remarkable inflance of the uncertainty of
the weather in this country,  than happened while I was writing thefe
notes.  This  morning,  Auguft  14, 1783,  the thermometer in  the
fhade was down  at fifty-three degrees,  and  a very few days ago ic
ftood above eighty.,  Tso one who reflects on fuch great and fudden
changes in the atmofphere, will be furprifed,  to find colds, coughs,
rheums, with  other affe&ion* of the  breaft and bowels, fo comjuqru.
j*  this epuutfy. 
[   IO°   ]
                        Night Air.

  THE perfpiration is often obftruaed by night-air ; even in fum-
mer, this ought to be avoided. The dews which fall plentifully af-
ter the hotteft day, make the night more dangerou? than when the
weather is cool. Hence,  in warm countries, the evening-dews are
more hurtful than where the climate is more temperate.
  It is very agreeable after a warm day, to be abroad in the cool
evening ; but this  is a  pleafure  to be avoided by all  who  value
their health.  The effeas of eve,ning-dews are gradual indeed, and
almoft imperceptible ; but  they are not the lefs to be dreaded:
We therefore advife travellers, labourers,  and all who are much
heated by day, carefully to avoid them.  When  the perfpiration
has been great, thefe become dangerous in proportion.  By not at-
tending to this, in flat marfhy countries, where the exhalations and
dews are copious, labourers are often feized with intermitting fe-
vers, qumfeys, and other dangerous difeafes.

                         —*ns£r»"'---

                       Damp  Beds.

  BE*DS become damp,either from their not being ufed, {landing
in damp houfes, or in rooms without fire.  Nothing is mere to be
dreaded by travellers than damp beds, which  are very common in
all places where  fuel is fearce.   When a traveller, cold and wet,
arrives at an inn, he may, by means of a good fire, warm diluting
liquor, and a dry bed, have the perfpiration reftorcd ; but if he be
put into a cold room, and laid on a damp bed, it  will be more ob-
ftruaed, and the worft confequences will enfue. Travellers fhould
avoid inns which are noted  for damp beds, as they would a houfe
infeaed with the plague,  as no man,  however  robuft, is  proof
againft the danger arifing from them.
  But inns are not the only  places where damp beds are to be met
with.  Beds kept in private families for the reception of ftrangers
are often equally dangerous.  All kinds of linen and bedding, when
not frequently ufed, become damp.  How then is it  poffible that
beds, which are not flept in above two or three times a vear, fliould
be fafe ? Kotliing is more common than to hear peop'le complain
e>f having caught cold by changing their bed. The reafon is obvi-
ous : Were they careful never to fleep in a bed but what was fre-
quently ufed, they would feldom find any  ill confequences from  a
change.
  Nothing is more to be dreaded by a delicate perfon, when on  a
vifit,than being laid in a bed which is kept on purpofe for ftrangers.
That ill-judged piece of complaifence becomes a  real injury.  AU 
     OF THE'COMMON  EVACUATIONS.      101

the bad confequences from this quarter might eafily be prevented
in private families, by caufing their fervants to fkep in the fpare-
beds, and refign them to ftrangers when they come. In inns, where
the beds are ufed almoft every night, nothing elfe is neceffary than
to keep the rooms well feafoned by frequent fires, and the linen dry.
   That baneful cuftom, faid to be praaifed  in many inns, of
damping fheets, and preffing them, in  order to fave wafhing, and
afterwards laying them on the beds, ought, when difcovered, to
be punifhed with feverity.  It is realty a fpecies of murder,  and
will  often p'rove as fatal as poifon or gun-fhot. Indeed, no linen,
efpecially if it has been wafhed in winter, ought to! be ufed until
it has been expofed for fome-time to the fire ;  nor is  this opera-
tion  lefs  neceffary for linen wafhed in fummer, if it  has lain by
for any length of time.  This caution is the more needful, as gen-
tlemen are often exceedingly attentive to what they eat or drink at
an inn, yet pay little regard to a circumftance of more importance*.
                       Damp Houfes

  FREQUENTLY produce the like ill-confequences ;  for this
reafon, thofe who build, fliould be careful to choofe a dry fituation.
A houfe which ftands on a damp, marfhy foil or deep clay, will ne-
ver be thoroughly dry.  All houfes, unlefs where the ground is ex-
ceeding  dry,  fhould have the firft floor a little raifed.  Servants
and others, who are obliged to live in cellars and funk flories, fel-
dom continue long  in health : Mafters ought furely to pay fome
regard to the  health of their fervamts, as  well as to their own.
  Nothing is  more common than for people, merely to avoid fome
trifling inconveniency, to hazard their lives, by inhabiting a houfe
almoft as foon as the mafons, plafterers,  See. have done  with it:
Such houfes are not only dangerous from their dampnefs,  but like-
wife from the fmell of lime,  paint,  &c.  The aflhmas, confump-,
tions, and other difeafes of the lungs, fo incident to people who
work  in thefe articles, are fufficient proofs,of their being unwhole-
ivimc.
  Rooms are often rendered damp by  an  unfeafonable  piece of
cleanlinefs ; I mean the pernicious cuftom of wafhing them imme-
diately before company is put into them.   Moft people catch cold,
if they fit but a very fhort time in a room  that has been lately wafh-


  •3f If a perfon fufpecls  that his bed is damp, the fimple precaution of
taking oft the  flieets  and lying in the blankets, with all, or moft of his
clothes on, will prevent  all danger. I have pra&ifed  this for  many
years, and never have been hurt by damp beds ; though no conftitution,
without car?,  is proof aga'mft their baneful  influence. 
102     OF  THE  COMMON  EVACUATIONS.

ed ; the delicate ought carefully to avoid fuch a.fituation, and eveo
the robuft are  not always proof againft its influence*.



           Sudden Tranfitions from Heat to Cold.

   PERSPIRATION is  frequently obftruaed by fudden tranfi-
tions from heat to cold. Colds are feldom caught,unlefs when peo-
ple have been  too much heated. Heat rarifies the blood, quickens
the circulation, and increafes the perfpiration ; but when thdfc are
fuddenly checked, the confequences muft be bad.  It is  impoflible
for labourers not to be too hot upon fome occafions ;  but  it is ge-
nerally in their power to let themfelves cool gradually, to put on
their clothes when they leave off work, to  make,  choice  of a dry
place to reft themfelves in, and to avoid fleeping in the open fields.
Thefe eafy rules, if obferved, would ofte« prevent fevers and other
fatal diforders.
   It is very common for people* when hot,  to drink freely of cold
water, or  fmall  liquors.  This condua is extremely dangerous.
Thirft indeed  is hard to bear, frequently gets the better  of reafon,  '
and makes us  do what our judgment difapproves.   Every  peafant,
however, knows, if his horfe0be permitted to drink his belly-full of
cold water after violent exercife, and be immediately put into the
ftable, or fuffered to remain at reft, that it will kill him.  This they
take the utmofl care to prevent. It were well if they were equally
attentive to their own fafety.
   Thirfl may  be quenched many ways without fwallowing large
quantities of cold liquor. The fields  afford  a variety of acid fruits
and plants, the very chewing of which would abate third. Water
kept in the mouth for fome  time, and fpit out again, if  frequently
repeated, will  have the fame effea.  If a bit of bread be eaten along
with a few mouthfuls  of water, it will both quench thirft more
effeaually, and make  the danger lefs. When a perfon is extreme-
ly hot, a mouthful of brandy, or other fpirits, if it  can be obtained,
ought to be preferred to any thing elfe. But if any one has been fo
foolifh, when  hot, as to drink freely of cold liquor, he  ought to
continue his exercife  at leaft,  till what  he drank be thoroughly
warmed upon his ftomach.                                   i
   It would be tedious to enumerate  all the bad effeas which flow
from drinking cold liquors when the body  is hot. Sometimes this
has occafioned immediate death.  Hoarfenefs, quinfevs, and fever*
of various kinds, are its common confequences. Neither  is it  fafe

   * People imagine, if a good fire is made in a room, after it has been
wafhed, that there is no danger from fitting in  it; but this increafes the
danger.  The evaporation excised by the are generates cold^and  rea-
ders the damp  more active. 
     OF .THE  COMMON EVACUATIONS.     103

When warm, to eat freely of raw  fruits, fallads,  or the like.
Thefe, indeed, have not fo fudden an effea on the body as cold
liquors, but they are notwithftanding dangerous, and ought to be
avoided.
  Sitting in a warm room, and drinking hot liquors till the pores
are quite open, and immediately going into the cold air, is ex-
tremely dangerous.  Colds, coughs and inflammations of the breaft,
are the  ufual effeas of this condua : Yet nothing is more com-
mon than for people, after they have drank warm liquors for feve-
ral hours, to walk or ride  a number  of miles in the coldeft night,
or to ramble about in the  ftreets*.
  People are very apt, when a room is hot, to  throw open a win-
dow, and to fit near it. This  is a moft dangerous praaice.  A per-
fon had better fit without-doors than in fuch a fituation, as the
current of air is direaed againft one particular part of the body.
Inflammatory fevers and confumptions have often been occafioned
by fitting or flanding thinly  clothed near  an open window. Nor
is fleeping with open windows lefs to be dreaded.  That ought ne-
ver to be done, even in the hotteft feafon, unlefs the window is at
a diftance.  Mechanics frequently contraa fatal difeafes, by work-
ing ftript at an  open window,  and I would advife all of them to
beware of fuch a praaice.
   Few filings expofe people more to catch cold, than keeping their
own houfes too warm ; fuch perfons may be faid to live in a fort
of hot-houfes; they  can hardly ftir abroad to vifit a neighbour^
but at the h?.zard of their lives.  Wp re there  no other reafon for
keeping houfes moderately cool', that alone is fufficient:  But no
houfe that is too hot can  be  wholefome; heat deflroys the fpring
and elafticity of the air, and  renders it lefe fit for' expanding the
lungs, and the  other purpofes of refpiration. Hence confumptione
and other difeafes of the  lungs prove fo fatal to people who work
in forges, glafs-houfes, and the like.
   Some are even fo fool-hardy, as to plunge themfelves when hat
in cold water.  Not only fevers, but  madnefs itfelf, has frequently
been the effea of this condua. Indeed, it looks too like the aaion
of a madman to deferve a ferious confederation.
   The refult of all thefe obfervations is, that  every one ought to
avoid, with  the utmoft attention, all fudden tranfitions from heat
to cold, and to  keep the body in as uniform a  temperature as pof-
fible ;  or, where that cannot be done, to  take care to let it cool
gradually.
   People may imagine that too ftria an attention to thefe things

  *  The tap-rooms in London  and other great towns, where fuch num-
bers of people fpend their evenings, .are highly pernicious.  The breath
of a number of people, crowded into alow apartment, with the addition
of fires, candles, the fmoke of tobacco, and the fumes of hot liquor,
&c. muft not only render it hurtful to continue in fuch places, but dan-
ger )u» to go out of them into a cold and chilly atmofphere. 
 io4     OF  THE COMMON EVACUATIONS.   ,

would tend to render them delicate. So far is this from being my
defign, that the very firft rule propofed for preventing colds, is to
harden the body, by enuring it daily to the open air.
 , I fhall put an end to this part of  my fubjea, by giving an ab-
ftraa of the advice of Celfus, with refpea to the prefervation of
health.  "A man," fays he, "who is blefled with good health,fhould
" confine himfelf to no particular  rules, either with refpea tore-
" gimen or medicine. He ought frequently to diverfify his man-
" ner of living; to be fometimes in town, fometimes in thecoun-
(t try to hunt, fail, indulge himfelf in reft, but more frequently to
" ufe exercife.  He ought to refufe no kind of food that  is com-
" monly ufed, but fometimes to  eat more and fometimes lefs;
" fometimes to make one at an entertainment, and fometimes to
" forbear it;  to make rather two  meals a-day than one,  and al-
(t ways  to eat heartily, provided he can digeft it. He ought neither
" too eagerly to purfue, nor too ferupuloufly to avoid, intercourfe
" with  the fair fex :  Pleafures of  this kind, rarely indulged, ren-
" der the body alert and aaive ; but, when too frequently fcpea-
" ted, weak and languid. He  fhould be careful in time of health
" not to deftroy, by excefles of any kind, that vigour of cohftittt- j
« tion which fhould fupport him under ficknefe." 
PART   II.
OF   DISEASES.
CHAPTER   XII.
          Of the Knowledge and Cure of Difeafes.

      THE knowledge of difeafes does not depend fo much upon
       feientific  principles as many imagine. It is chiefly the re-
 fult of experience and obfervation. By attending the fick, and1 care-
 fully obferving the various occurrences in difeafes, a great degree
 of  accuracy may be acquired, both in diftinguifhing their fymp-
 toms, and in the application of medicines.  Hence, fenfible nurfes,
 and other perfons who wait upon the  fick, often difcover a dif-
 eafe fooner than thofe who have been, bred to phyfic. We do not
 infinuatc that  a  medical education is of no ufe : it is doubtlefs of
 the greateft importance; but it never  can fupply the place of ob-
 fervation and experience.
   Every difeafe may be confidered as an affemblage of fymptoms^
 and muft be diflinguifhed by thofe which are moft obvious and
 permanent. Inftead, therefore, of giving a claflical arrangement of
 difeafes, according to the fyftematic method, it will be more fuit-
 able, in a performance of this nature,  to give a  full and accurate
 defcription of each particular difeafe as it occurs ; and, where any
 of the fymptoms of  one difeafe have a  near refemblance to thofe
 of another, to take notice of that circumftance, and at  the fame
 time to point out  the  peculiar  or charaaeriftic fymptoms by
 which it may  be diflinguifhed.  By a due attention to  thefe, the
 inveftigation of difeafes will be found lefs difficult than moft peo-
 ple would imagine.
  A proper attention to the patient's age, fex, temper of mind, con-
 ftitution, and manner of life, will greatly affift, both in the invefti-
 gation and treatment of difeafes.
  In childhood,  the fibres are lax and  foft, the nerves extremely
 irritable,and the fluids thin: whereas,in old age,the fibres are rigid*
the nerves become almoft infenfible, and many of the veffels im-
perviable.  Thefe,and other peculiarities,render the difeafes of the
young and aged very different^ and of courfe, they muft  require a
different method of  treatment. 
 106            OF  THE  KNOWLEDGE.

   Females are liable to many difeafes which do not afflia the other
 fex : befides the nervous fyftem being more irritable in them than
 in  men, their difeafes require to be treated with  greater caution.
 They are lefs able to bear large evacuations ; and all  flimulating
 medicines ought to  be adminiftered to them with a fparing hand.   i
 -  Particular conftitutions not only difpofe perfons to peculiar dil-
 eafes, but likewife render it neceffary to  treat thefe  difeafes in a
 peculiar manner.  Adelicate perfon, for example, with weak nerves,
 who lives moftly within doors, mutl not be treated, under any dif-   '
 eafe, precifely in the fame manner as one who is hardy and robuft,
 and who is much expofed to the open air.
   The  temper of mind ought to be  carefully attended to. Fear,
 anxiety, and a fretful temper, both occafion and aggravate difeafes,  ,
 In  vain do we apply medicines to the body to remove maladi?*
 which proceed from the mind.  When it  is affeaed, the beft me-
 dicine ^is to footh the paflions, to divert  the mind from anxious
 thought, and to keep the patient as eafy and cheerful as poffible.
   Attention ought  likewife  to be paid to the  climate, or place .
 where the patient lives, the air he'breathes, his diet, &c. Such as
 live in low marfhy  fitualions are fubjea to many difeafes which
 are unknown to the inhabitants of high  countries.  Thofe  who
 breathe  the impure air of  cities,.have many maladies to which ths
 more happy ruftics are entire ftrangers. Perfons who feed grofsly,
 and indulge in ftrong liquors, are liable to difeafes which do not
 affea the temperate and abftemious, Sec.
  It has already been obferved, that the different occupations and
 fituations in life difpofe men to peculiar difeafes. It is  therefore
 neceffary to enquire into  the patient's occupation, manner of hfe,
 &o This will not only affift us in finding  out the  difeafe, hut wilt
 likewife direa us in the treatment of it. It would be very impru-
 dent to  treat the laborious and the fedentary precifely in the  fame
 manner, even fuppofing them to labcur under the'fame difeafe.
  It will be proper to enquire, whether the difeafe be conlluution-
 al or accidental;  whether it has been  of long or  fhort duration;
 whether it  proceeds from any great and fudden alteration  in the  j
 diet, manner of life, &c.  The ftate of the patient's body,  and  of
 the other evacuations, ought alfo to be enquired into ; and whether
 he can with eafe perform all  the vital and animal funaions, as
 breathing, digeftion, &c.
 " Laftly, it will be proper to enquire what difeafes the patient has
 formerly been liable to, and what medicines were moft  beneficial;
 lo him, if he has a ftrong avcrfion to any particular drug,  &c.
  As many of the indications  of  cure may be anfwered  by diet
 alone, it is always the firft thing to be attended to in the  treatment
 of difeafes.  Thofe who know no  better, imagine that every thing
 which goes by the  name  of a medicine poffefles fome wonderful
 power or fecret charm, and  think, if the patient fwallows enough
«f drugs, that he muft-do well.  This miflakehas many ill confe- 
             AND CURE OF  DISEASES.          to?

«mcnces; it makes people trull to drugs, and neglea their own en-
deavours ; befides, it difeourages all  attempts to  relieve the  fick
where medicines cannot be obtained.
  Medicines are no doubt ufeful in  their place, and, when admi-
niftered with prudence, they may do much good ; but when they
are put in place of every thing elfe, or adminiftered at random,
which is not feldom the cafe, they muft do mifchief.  We therefore
wifli to call the attention of mankind from the purfuit of fecret
medicines, to fuch things as they are acquainted with.* The proper
regulation of  thefe may often do much good, and there is little
danger of their ever doing hurt.
  Every  difeafe weakens the digeflive  powers.  The diet ought,
therefore, in all difeafes, to be light and of eafy digeftion. It would
be as prudent  for a perfon with a broken leg to attempt to walk,
as for one in a fever to eat the fame kind of food, and in the fame
quantity, as when he was in perfea health.  Even abftinence alone
will often  cure a fever, efpecially when it has been  occafioned by
■excefs in eating or drinking.
   In all fevers attended with inflammation, as pleurifies, peripneu-
m.onies, &c. thin gruels, wheys, watery infufions of mucilaginous
plants, roots, Sec. are not only proper for the patient's food,  but
they are likewife the beft  medicines which can be  adminiftered.
   In fevers of a flow, nervous, or putrid kind, where there are no
fymptoms cf inflammation,  and where the patient muft be fup-
ported with cordials, that intention can always be more effeaually
anfvveredby nourifhing diet and generous wines, than by any  me-
dicines yet known.
   Nor is a proper attention to diet of lefs importance  in chronic
than in acute  difeafes. Perfons alHiaed with low  fpirits,  wind,
weak nerves, and other hypochondriacal affeaions,  generally  find
more benefit from the ufe of folid food and generous liquors, than
from all the cordial and carminative medicines which can be ad-
miftered to them.  The feurvy will fooner yield to a proper vege-
table diet, than to all the antifeorbutic remedies of the fliops.
   In confumptions, when the ftomach is fo much weakened as to
be unable to digeft the  folid fibres of animals, or even to affimilate
the juices of vegetables, a diet confifting chiefly of milk will not only
fupport. the patient,but will often cure the difeafe after every other
medicine has failed.
   Nor is  an attention to other things of lefs importance than to
diet. The ftrange infatuation which has long induced people to
fhut up the fick from all communication with the external air, has
done great mifchief. Not only in fevers but in many other difeafes,
the patient will receive more benefit from having the frefh air,
prudently admitted into his chamber, than from all the medicines
which can be given him.
   Exercife may likewife in many cafes be confidered as a medicine.
Sailing, or riding on horfeback, for example, will be of more  fer* 
?o8          OF FEVERS IN  GENERAL.

vice in the cure of confumptions, glandular obftruaions, Sec. than
any medicine yet known.  In difeafes which proceed from a relaxed
ftate of the folids, the cold bath, and other parts of the gymnaflic
regimen, will be found equally beneficial.
   Few things are of  greater importance in  the cure  of  difeafes
than cleanlinefs. When a patient is fuffered to lie in dirty clothes,
"whatever perfpires from his  body is again reforbed, or taken up
into it, which ferves to nourifh the  difeafe and increafe the danger.
Many difeafes may be cured  by cleanlinefs alone;  moft  of them
may be mitigated by it, and in all of them it is highly neceffary
both, for the patient and thofe who attend him.
   Many other obfervations, were it neceffary, might be  adduced
to prove the importance of a proper regimen in difeafes. Regimen
will often cure difeafes without medicine, but  medicine  will feldom
fucceed where a proper regimen is negfeaed.  For this reafon,in the
treatment of difeafes, we have always given the firft place to regi-
men. Thofe who are ignorant of medicine may confine themfelves
to it only. For others, who  have more knowledge, we have recom-
mended fome of the moft fimple but approved forms of medicine
in every difeafe. Thefe, however,  are never to be adminiftered bqt
by people of better underftanding; nor even  by them without the
greateft precaution.
                CHAPTER  XIII.

                   Of Fevers in  General.

      MORE than one half of mankind are faid to perifh by fevers,
       Their moft general caufes ar-e infeBion, errors in diet, un-
'wholefome airy violent emotions of the mind, excefs or fuppreffton of ufual
evacuations, external or internal injuries, and extreme degrees of heat $r
told. As moft of thefe have already been treated of at considerable
length, and their effeas fhown, we fhall not  now refume the con-
sideration of them, but only recommend it to all, as they would
wifh to avoid fevers and other fatal difeafes, to pay the moft punc-
tual attention to thefe articles.
   Fevers are not only the moft frequent of all difeafes, but they are
likewife  the moft. complex.  In the moft fimple  fpecies of fever
there is always a combination of  feveral different fymptoms. The
diftinguifhing fymptoms of fevers are, increafed heat, frequency of
pulfe, lofs of appetite, general debility, pain in the head, and a difficult)
in performing fome of the "vital or animal funtlions.  The other fymp-
toms, ufually attendant on fevers are, naufea, thirft, anxiety, de-
lirium,  wearinefs, wafting of the flefh, want of fleep, or the fleep
difturbed and not refrefhing.
   When the fever comes on gradually,  the patient generally com^ 
OF  FEVERS IN GENERAL.
109
  plains firft of langour or liftleffnefs^forenefsof the flefh or the bones,
  heavinefs of the head, lofs of appetite, ficknefs, with clamminefs
  of the mouth ; after fome time come on exceffive  heat, violent
  thirft, reftleflhefs, &c.
    When the fever attacks fuddenly,  it always begins with an un-
  eafy fenfation of e.tceffive cold, accompanied  with debility and
  lofs of appetite ;  frequently the cold is  attended with fliivering,
  oppreffion about the heart, and ficknefs at ftomach,  or vomiting*
    Fevers are divided into continual,  remitting, intermitting, and
  fuch as  are attended with cutaneous eruption or topical inflam-
  mation,  as the fmall-pox, eryfipclas, &c.  By a continual fever is
  meant that which never leaves the patient during the whole courfe
  of the difeafe, or which  fhows no remarkable  increafe or abate-
  ment of the fymptoms. This kind of fever is likewife divided into
  acute, flow, and malignant.  '1 he fever is called acute when its pro-
  grefs is quick, and  the  fymptoms  violent ; but when thefe are
  more gentle, it is  generally denominated foiv.  When with livid
  or petechial fpots, the fever is called malignant, putrid, or petechial.
    A remitting fever differs  from a continual only in degree.  It
  hss frequent increafes and decreafes, or exacerbations  and remifi-
  fions,but never wholly leaves the patient during the courfe of the
  difeafe.  Intermitting fevers or agues are thofe, which, during the
  time that the  patient may be faid to  be ill, have evident intervals
  or remiffions of the fymptoms.
    As a  fever is only an  effort of Nature to free herfelf from an
  offending caufe,  it is the  bufinefs of thofe who have  the care  of
 • the fick, to obferve with diligence which way Nature points, and
  to endeavour to affiit her  operations.  Our bodies are fo framed,
  as to have a conflant tendency  to expel or throw off whatever is
  injurious to health.  This  is generally done by urine, fweat, flool,
  expeaoration, vomit, or fome other evacuation.
    There is reafon to believe, that if the efforts of Nature, at the
  beginning of a fever, were duly attended to and promoted, it would
  feldom continue long ; but when her attempts are either negfea-
  ed or counteraaed, it is no  wonder if the difeafe proves fatal.
  There are daily inftances of perfons, who after catching cold, have
  all the fymptoms of a beginning fever; but by  keeping  warm,
  drinking diluting  liquors, bathing their feet in warm water, &c.
  the fymptoms in a few hours difappear, and the danger is prevent-
v ed. When fevers of a putrid kind threaten, the beft method of ob-
  viating their effeas is by repeated vomits.
    Our defign is to mark the moft obvious fymptoms in fevers, and
  to point out the proper treatment of the patient with refpea  to his
  diet, drink, air, &c. in the different ftages of the difeafe. In thefe
  articles,  the inclinations of the patient will, in a great meafure,
  direa our condua.
    Almoft every perfon in a fever complains of great thirft, and
  falls out for drink, efpecially of a cooling nature.  This at once 
no
OF  FEVERS IN  GENERAL.
   points  out the ufe of water, and other cooling liquors.  Whatia
   fo likely to abate  the heat,  remove fpafms and obftruaions, pro-
   mote perfpiration, increafe  the quantity of unna, and,  in ftiort, •
   produce every falutary cifea, in an ardent or inflammatory fever,
   as drinking plentifully of water, thin gruel, «or any other weak
   liquor, of which water-is the bafis?  The  neceffity of diluting li-
   quors is pointed out b^ the dry tongue, the parched  fkin, and the
   burning heat, as well as by the unquenchable thirft of the patient.
      Many cooling liquors, which are extremely grateful to patients
   in a fever, may be prepared from fruits ;  as decoaions of tama-
   rinds, apple-tea, orange-a hey, and the like. Mucilaginous liquors
   might  alfo be prepared from marfhmallow-roots, linfeed, lime-
v   tree buds,  and other mild vegetables.  Thefe liquors,  efpecially
   when acidulated,  are highly agreeable to the  patient, and fhould
   never be denied him.                                          '
      At the beginning of a fever, the patient  generally  complains of
   great laffitude or wearinefs, and has no inclination to move.  Thij
   evidently fhows the propriety of keeping him eafy, and, if poffible,
   in bed. Lying in bed  relaxes the fpafms, abates the violence of
   the circulation,  and gives Nature an opportunity of exerting all
   her force  to  overcome the  difeafe.  The  bed alone would often
   remove a fever at the  beginning ; but when the patient  flruggles
   with the difeafe, inftead of driving it off, he only fixes it the dee-
   per, apd renders it mere dangerous.   This  obfervation is  too often
   verified in travellers, who'happen, when on a journey, to be feized
   with a fever.  Their anxiety to get home  induces them to travel
   with the fever upon them, which condua feldom fails to render it
   fatal.
      In fevers,  the mind as  well as the body  fhould  be kept eafy.
   Company is feldom agreeable to the fick.' Every thing that difturbs
   the imagination irfcreafes the difeafe; for which reafon, every per-
   fon in avfever ought to be kept perfeaiy quiet, and neither allow-
   ed to fee nor hear any thing that may in the leafl affea or difcorn-
   pofe his mind.
     Though the patient in a  fever has the  greateft inclination for
   drink, yet  he feldom has any appetite fqr  folid food ;  hence, the
   impropriety of urging him to take viauals, is evident. Much folid
   food in a fever is  every way hurtful: It oppreffes Nature, and in-
   ftead of nourifhing  the patient,  ferves only to feed the difeafe.
   What food the patient takes fhould b<? in fmall quantity, light, and
   of eafy digeftion.  It ought to he chiefly of the vegetable kind, as
   panada, roafted apples, gruels, and fuch like.
      Pocr people, when any of their family are taken ill, run direclly
   to their rich neighbours for cordials,  and pour wine, fpirits, &c
   into the patient, who, perhaps, never had been accuftomed to tafte
   fuch liquors  when  in health.  If there be any  degree  of fevtt,
   this condua muft increafe it, and if there be none, this is the rea-
   dy way to raife  one.   Stuffing the patient with fweet-meats and 
OF  FEVERS IN GENERAL.
r 11
other delicacies, is likewife very pernicious.  Thefe  are  always
harder to digeft than common food, and hurt the ftomach.  .
   Nothing is more defired by a patient in a fever, than frefh air.
It not only removes his anxiety, but cools the blood, revives the
fpirits, and  proves every way beneficial.  Many patient? are in a
manner  ftifled  to death in fevers for want of freih air ; yet fuch
is the unaccountable infatuation of moft people, that the moment
they think a perfon in a fever, they  imagine he fhould be kept in a
clofe chamber, into which not one particle of frefh air mull be ad-
mitted.  Inftead of this, there ought to be a conflant ftrsam of frefh
air into a fick perfon's chamber, fo as  to keep it moderately cool.
Indeed, its degree of warmth ought never  to  be  greater than is
agreeable to one in  perfea health.
   Nothing fpoils the ;ur of a fick perfon's chamber, or hurts die pa-
tient moie, than a number of people breathing in it.   When the
blood is inflamed, air that has been breathed repeatedly will great-
ly increafe the difeafe.  Such air not only  lofes its fpring, and be-
comes unfit for the purpofe of refpiration, but acquires a noxious
quality, which renders  it in a manner poifonous to the  fick.
   In fevers, when the patient''.) fpirits are low and depreffed', he is
not only to be fupported with cordials, but every method fhould
be taken to cheer and comfort his mind. Many, from  a miftaken
zeal, when they think  a  perfon in  danger, inftead of folacing hi*
mind with the hopes and confolations of religion, fright him with
the views of hell and damnation.  It would be unfuitable  here to
dwell upon the impropriety and dangerous confequences of this
condua.
   Among common people, the very name of a fever generally fug-
gefts the neceffity of bleeding. This notion feems to have taken its
rife from moft  fevers in this country having been  formerly of an
inflammatory nature ; but true inflammatory fevers are now feldom
to be met with. Sedentary occupations, and a different manner of
living, have fo changed the ftate  of difeafes in Britain, that there is
now hardly one fever in ten where the lancet is neceffary. In low,
nervous fevers, which are now fo common, bleeding is really hurt-
ful, as it weakens the patient, finks his fpirits, &c.  We would re-
commend this general  rule, never to bleed at the beginning of a
fever, unlefs there be evident figns  of inflammation.  Bleeding is
an excellent medicine when neceffary,  but  fhould never bs wan-
tonly performed.                r
   It is likswife a common notion, that fweating is always neceffary
in the beginning of a fever. When  the fever proceeds from an ob-
ftruaed perfpiration, this notion is not ill-founded.  If the patient
only lies in bed, bathes his feet and  legs in warm water, and drink*
freely of water-gruel, or any othsr weak diluting liquor,  he will
feldom fail to perfpirc  freely.  The warmth of the bed, and the
diluting drink,  will  relax the ur.iverfal fpafin, which generally af-
fects tlis fkin at th* beginning of a fever; it will ope;: the pores, 
112
OF  INTERMITTING FEVERS,
and promote the perfpiration, by means  of which the fever may
often be carried off.  But inftead of this, the common practice 19
to heap  clothes upon- the patient, and to give him things of a hot
nature, as fpirits, fpiceries, Sec.  which  increafe the fpafms, and
render the difeafe more dangerous.
   In all fevers, a proper attention fliould be paid to the patient's
longings. Thefe are the calls of Nature, and often point out what
may be of real ufe.  Patients are not indeed to be indulged in every
thing that the fickly appetite  may crave ; but it is generally right  ,
to let them have a little of what they eagerly defire, though it may
not feem altogether proper.  What the patient longs for,  his fto-
mach will generally digeft; and fuch things have fometimes a very
happy effea.
   When a patient is recovering from a fever, great care is necef-
fary to prevent a relapfe.  Many perfons, by  too foon imagining
themfelves well,  ha^e loft their lives, or contraaed other difeafes 1
of an obftinate nature. As' the body after a fever is  weak and dc- ■■
licate, it is neceffary to guard againft catching cold.  Moderate
exercife  in the open air will be of ufe, but great fatigue is by all
means to be avoided ; agreeable company  will alfo have  a good
effea. The diet muft be light, but nourifhing. It fhould be taken
frequently, but in fmall quantities. It is dangerous at fuch a time
to eat as much as the ftomach may crave,

                         1.

                  CHAPTER   XIV.

              Of Intermitting Fevers, or Agues.

   INTERMITTING fevers  afford  the beft opportunity both of
    obferving the nature of a fever, and alfo the effeas of medicine.
No perfon can be at  a lofs to diftinguifh  an intermitting fever
from any other, and the proper medicine  for it is now almoft uni-
verfally known.
   The feveral kinds of intermitting fevers take their names from
the period  in which the  fit returns, as quotidian, tertian, quar-
tan, &c.
   CAUSES.----Agues  are  occafioned  by effluvia from putrid
flagnating water. This is evident from their abounding in rainy
feafons,  and  being moft frequent in  countries where the foil is
marfhy.  This difeafe may alfo be occafioned by eating too much
flone fruit, by a poor watery diet, damp houfes, evening dews, ly-
ing upon the damp ground, watching, fatigue, depreffing paflioityi
and the like.  When the inhabitants of a high country remove to
a low one, they are  generally feized with intermitting fevers, and
to fuch the difeafe is moft  apt to prove fatal.  In a word, whatever'J
relaxes the  folids,  diminishes the perfpiration, or obftrua^  the 
           OF INTERMITTING  FEVERS.        jjj

circulation in the capillary or fmall veffels, difpofes the body to
agues.
  SYMPTOMS.----An intermitting fever generally begins with
a pain of  the head and loins, wearinefs of the limbs, coldnefs of
the extremities, ftretching, yawning, with fometimes great ficknefe.
and vomiting; to which fucceed, fhivering and violent ihaking.
Afterwards the fkin' becomes moift. and a profufe fweat breaks
out which generally terminates the fit or paroxyfm.  Sometimes
the difeafe comes on  fuddenly, when  the perfon thinks himfelf in
perfea health; but it- is more commonly preceded by liftleifiuefs,
lofs of appetite, and  the fymptoms mentioned above.
   REGIMEN.——While the fit continues, the patient ought to
drink freely of water-gruel, orange-whey, weak camomile tea ; or,
if his fpirits be low, fmall wine-whey, fharpened with the mice of
lemon. All his drink fhould be warm, as that will affifl in bringing
on  the fweat, and confequently fhorten the paroxyfm*.
   Between the paroxyfms the patient muft be fupported with food
that is nourifhing, but light and eafy of digeftion, as veal or chick-
en  broths, fago, gruel with a little wine, light puddings, and fuch-
like.  His  drink may be fmall negus, acidulated with the juice of
lemons or oranges, and fometimes a little weak punch.   He  may
likewife drink infufions of bitter herbs, as  camomile, wormwood,
or  water-trefoil, and may now-and-then take a glafs of fmall wine,
in  which  gentian root, centaurv, or fome other bitter, has been in-
fufed.
    As the  chief intentions of cure in an ague are to brace the folids,
and promote perfpiration, the patient ought to take as much exer-
cife between the fits as he can bear. If he is able to go abroad, rid-
ing on horfeback, or in a carriage, will be of great fervice. But if
he  cannot bear that kind of exercife,  he ought to take fuch as his
ftrength wdl permit.  Nothing tends more to prolong an intermit-
ting fever, than indulging a lazy, indolent difpofition.
   Intermitting fevers,  under a proper regimen, will often go off
without medicine ;  and when the difeafe is mild,  in an open dry
country,  there is feldom any danger from  allowing it to take its
courfe ; but when the patient's  ftrength feems to decline, or the
paroxyfms are  fo violent that his  life is in danger, medicine ought
immediately to be adminiftered.   This, hoSvever, fhould never be
done till  the difeafe be properly formed, that is to fay, till the pa-
tient has  had feveral fits of fhaking and fweating.
    MEDICINE.----The  firft thing  to be  done in  the cure of an
intermitting fever, is to cleanfe the ftomach and bowels. This ren-
ders  the application of other medicines more fafe  and efficacious*

   ■fc  Dr.  Lind fays, that twenty or twenty-five drops of laudanum put
into a cup of the patient's drink, and given about half an hour after the
commencemeatof the hot lit, promotes the fweat. fliortens tbe fit, re*
 lieves the head, and tends greatly to remove the difeafe.
P 
 11 v        OF INTERMITTING  FEVERS,

 In this difeafe, the ftomach is generally  loaded with cold viferd
 phlegm, and frequently great quantities of  bile are diichar-ed by
 vomit;  which points out the neceffity of l\lch evacuations.  Vomits
 are -therefore to be adminiftered before the patient takes any other x^
 medicine. A dofe of ipecacuanha will generally anfwer  this pur-
 pofe Very well.  A feruple or half a dram of the powder will be
 fufficient from . n adult, and for a younger perfon the dole muft be
 lefs in proportion.  After the vomit begins to operate, the patient
 dught to drink plentifully of weak camomile-tea. The vomit fhould
 be taken two or three hours before the return of the fit, and may
 be repeated at the diftance of two or three days.  Vomits ndtonly
 cleanfe the ftomach, but increafe the perfpiration and  ail the other
 fecretions, which render  them of fuch  importance, that  they of-
 ten cure intermitting fevers without the alfiltance of any other me-
 dicine.
  Purging medicines are ufeful and often neceffary in intermitting   i
 fevers.  A iiuart purge has cured anobftinate ague,after the bark and
 other medicines had been ufed in vain.  Vomits are more fuitable   i
 in .this difeafe,  and render purging lefs necedary ; but if  the pa-
 vient be afraid to take a vomit, he ought io cleanfe the bowels by
 .1 dofe or two of Glauber's fait or jalap.
  Bleeding  may fometimes be proper at the beginning of an inter-
 mitting fever, when exceffive heat, a delirium, Sec. give reafon to
 fufpea  an iniiamniation;  but as the blood is feldom in an inflam-
 matory  ftate in intermitting fevers, this operation is rarely neceffary.
 When frequently repeated, it tends to prolong the difeafe.
  After proper evacuations, the patient may fafely ufe the Peruvian
 bark, which may be taken in any way  that is moll  agreeable to
 him. No preparation of the bark feems  to anfwer better than the
 moft fimple foim in which it can be given, viz. in powder.
  Two ounces of the beft bark, finely powdered, may be divided into
 'twenty-four dofes. Thefe may either be made into bolufles as they
 are ufed, with a little fyrup of lemon, or mixed in a glafs of red
 wine, a cup of camomile-tea, water-gruel, or any other drink that
 is more agreeable to the patient*.
  In an ague  which returns every  day, one of the above dofes
 may be  taken every two hours, or oftener during the interval of the
 fits.  By this method, the patient will be able to take five or fix dofes
 between each paroxyfm. In a tertian or third-day ague, it will be
 fufficient to  take a dofe every third hour during the interval, and
 in a quartan every fourth. If the patient cannot take fo large a
 dofe of the  bark,  he may divide each  of  the powders into two
 parts, and take one every hour, &c. For  a young perfon, a fmallei  !

  -* It has lately been obferved, that the red bark is more powerful than
 that which has for fome time been in common ufe. Its fuperior efficacy
feems to arife from its being of a more perfect growth than the quill bark, • '
 and confequently more ftihy impregnated with the medical properties
 of the plant. 
           OF INTERMITTING FEVERS.          115

<r-.mntity of this medicine will be fufficient, and the dofe muft he-
adapted to the  age, conftitution, and violence  cf the fymptoms".
  The above quantity of bark will frequently  cure mi ague ; the
patient, however, ought not to leave off taking the medicine as foon
as the paroxyfms are flopped, but fliould continue to ufe it till there
is reafon to believe the difeafe entirely overcome. Moft failures in
the cure are owing to patients not continuing to ufe the medicine
long enough.  They are generally direaed to take it till the fits are
flopped, then to leave  it  off, and  begin again at feme diftance of
time ;  by which means the difeafe gathers ftrength, and often re-
turns with as much violence as before.  A rclapfe may be prevented
by the patfeiic's continuin:; to take fmall dofes of  the medicine for
fome time after the fymptoms difapnear.  This  is tire moft fafe me-
thod of cure.
   An ounce of gentian root, calamus aromaticus, and orar.ge-pecl,
of each half an ounce, with three or four handfuls of  camomile-
flowers, and an handful of coriander-feed, all bruifed together in a
mortar, may be  ufed in form or  infufion of tea.  About half an
handful of thefe-  ingredients may be put into a tea-pot,  and an
Englifh pint of boiling water poured on them.  A cup of mis infu-
fion. drank three or four times a dav, will greatly promote the cure.
Such patients as cannot drink the watery infufion, may put two
handfuls of the fame  ingredients  into a bottle of white -wine, and
take a glafs of it twice or thrice a day.  If patients drink freely of
the above, or any other  proper infufion of bitters, a fmaller quan-
tity of  bark than is  generally ufed, wiil  be fuflicient to cure an
aguef.
   Thofe  who cannot fwallow the bark in fubftance, may  take it
in decodlion or infufion. An ounce of bark in powder may be  in-
 fufed  in a bottle of white wine  for four or five days, frequently
 fliaking the bottle, afterwards let the powder fubfide, and pour off
 the clear liquor.   A  wine-glafsful  may  be drank three or four

   •^ In intermitting-fevers of an obfKr.j.te nature, I have fornd it "?-
 ctilb'-y to throw in the bark much fafter. The benefits arifing from this
 medicine, depend ci:;e;Iy upon a large quantity of it being adinin;(kred in
 a, fhort time. Several ounces of bark given in a few days will do more
 than as many pound; taken in  the  courfe of fome v. te!;s..  When this
 medicine is intended either to flop a mortification.' or cure an obftinate
 ague, it ought to be thrown in as fail as the ltomach can pofiibly bear it.
 Inattention to this circuinflance has hurt the reputation of one of the belt
 medicines of which we are in polfefiion.
   f  There is reafon to believe, that fun dry of our own plants pr bark%
 which are very bitter and aftringent,  would fucceed in the cure of in-
 termitting fevers, efpecially when afliiled by aromatics.  But as Peruvian
 bark has been long approved in the cure of this difeafe, and i$ now to
 be obtained at a very reafoijable rate, it is of Lefs importance to fearch
 after new medicines. We cannot however omit taking notice, that Peru-
 vian bark is very often adulterated, and that it requires conliderable Ikiil
 to diftinguifh between the genuine and the  f'alfe. This ought to make
 people very cautious of whom they purchafe it.

                                           \ 
              OF, INTERMITTING FEVERS.

  times a day,  qr oftener,  as there is occafion. If a decoaion be
  more agreeable, an ounce of the bark, t and two drams of fnake-
  root bruifed, with an equal quantity of fait of wormwood, may be
  boiled in a quart of water, into an Englifh  pint.   To the ftrained
  liquor may be added ah equal quantity of red wine, and a glafs of
  it taken frequently.                                             ''
    In obflinate agues,  the bark will be found much more effica-   ,
  cious when affifted by brandy, or other warm cordials, than taken.
  alone.  This I have had frequently occafion to obferve in a coun-
  try where intermitting fevers were endemical.  The bark feldom
  fucceeds unlefs affifted by fnake-root, ginger, canella alba, or fome
  other warm aromatic. When the fits are very frequent and violent,
  in which cafe the fever often approaches towards an inflamma-
  tory nature, it will be  fafer to keep out the aromatics, and to add
  fait of tartar in their Head. But in an obflinate tertian or quartan,
  in the end of autumn  or beginning of winter, warm and cordial
  medicines are abfolutely neceffary*.
    As autumnal and winter agues generally  prove much more ob-
  flinate than thofe  which attack the patient in fpringor fummer,
  it will be neceffary to continue the ufe of medicines longer in the
  former than in the latter.  A  perfon who is feized with an inter-
  mitting fever in  the beginning of winter, ought frequently, if the
  feafon proves rainy, to  take a  little medicine, although the difeafe
  may feem to be  cured, to prevent a relapfe, till the return-of the
  warm feafon.  lie ought likewife to take care  not to be much
  abroad in wet weather, efpecially in cold eafterly winds.
    When agues are not properly cured, they often degenerate into
  obflinate chronical difeafes, as the dropfy, jaundice, &c.  For this
  reafon,  all  poffible care fhould be taken to have them radically
  cured, before the conftitution has been too much weakened.
   Though  nothing is more rational than the  method of treating
  intermitting fevers, yet, by fome ftrange infatuation, more charms
  and whimfical remedies are daily ufed for removing this than any
  other difeafe.  There is hardly an old woman who is not in pofief-
  lion of a noflrum for flopping an  ague : and it is amazing with
  what  readinefs their pretenfions are believed.  Thofe in diftrefs
 eagerly grafp at any thing that promifes  fudden relief ;  but the
 lhorteft  way is not always the beft in the  treatment of difeafes.
 The only method to obtain a fafe  and lafling cure, is gradually to
 aflift Nature in removing the caufe of the diforder.
   Some, indeed,  try bold, or, rather, fool-hardy  experiments to

   £ In_obflinate agues, when the patient is old, the habit phlegmatic,
 [!,_• feafon rainy, the fituation damp, or the like, it will be necelfary to  J
 n.'.s. with tv, D ounces of the bark, half an ounce of Virginian fnake-
 » -mi t, and a quarter of an ounce of ginger, or fome other warm aromatic j
. but whf n the fymptoms  are of an intlammatory nature, half an ounce
 of fait of wormwood, or fait of tartar, maybe added, to the above qnan-
 iity of hark. 
OF  INTERMITTING  FEVERS.
117
 cure agues, as drinking great quantities of ftrong liquors, jumping
 into a river, &c*.  Thefe may fometimes have the defired effea,
 but muft always be attended with danger.  When there is any de-
 gree of inflammation, or the leaft tendency to it, fueh experiments
 may prove fatal.  The only patient whom I remember to have loft,
 in an intermitting fever, evidently killed himfelf by drinking ftrong
 liquor, which fome perfon had perfuaded him would prove an in?
 fallible remedy.  .
   Many dirty things are extolled  for the  cure of intermitting fe-
 vers, as fpiders, cobwebs, fnuffings of candles, &c.  Though thefe
 may fometimes fucceed, yet their very naftinefs is fufficient to fet
 them afide, efpecially w,hen cleanly medicines will anfwer the pur-
 pofe better. The only medicine that can be depended upon, for
 thoroughly curing an intermitting fever, is the Peruvian bark.  It
 may always be ufed with fafety; and I can honeftly declare, that
 in all my  praaice, I never knew it fail, when combined  with the
 medicines mentioned above, and duly perfifted in.
   Where agues  are endemical, even children are often  afniaed
 with that difeafe.  Such patients are very difficult to cure, as they
 can feldom be prevailed upon to take the  bark, ov any  other difa-
 greeable medicinef. One method of rendering this medicine more
 palatable, is to make it into a mixture with diftilled waters and fy
 rup, and afterwards to give it an agreeable fharpnefs with  the elix-
 ir or fpirit of vitriol. This both improves the medicine, and takes
 off the naufeous  tafte. In cafes where the  bark  cannot be admini-
 ftered, the faline mixture may be given with advantage to children J.
   Wine-whey is a very proper drink for a child in an ague ; to half
 an Englifh pint of which, may be put a tea-fpoonful of the fpirit of
 hartfhorn.  Exercife is likewife of confiderable fervice ;  and when
 the difeafe proves obflinate, the child ought, if poffible, to be remo-
 ved to a warm, dry air.  The  food  ought to be nourifhing,  and
 fometimes a little generous wine fhould be allowed.
   To children, and fuch as cannot fwallowthe bark, or when the
 ftomach will not bear it, it may be given by clyfler. Half an ounce
 of the extraa of bark, diffolved in four  ounces of warm-water,
 with the addition of half an ounce of fweet-oil, and fix or eight
 drops of laudanum, is the form recommended by Dr. Lind for an
 adult, and this to be repeated every fourth hour, Qr oftener, as the
 occafion fhall require.  For children, the  quantity of extraa  and

  ■* Arfnic is among the number of thefe bold, injudicious remedies;
 and ought never  to be  ufed in any cafe of  intermitting fever what-
 ever.     (I-C.)
  t When children cannot take the medicine recommended, they may
 be frequently cured by giving ten or fifteen drops of laudanum^ accor*
ding to the age of the patient, about half an hour  before the cold ftage
 commences.    (I.C.)
               i See Appendix, Saline mixture. 
 nS     CF AN ACUTE CONTINUAL FEVER.

laudanum muft be proportionally ieffened.   C'-ildren have, been
cured of agues by making them wear a waiftcoat with powdered bark
quilted between the folds of it ;  by bathing tliem frequently in a
ftrong decoaion of the bark, and by rubbing the fpine with ftrong
fpirits, or with  a mixture of equal parts of laudanum, and the  fa-
ponaceous liniment.             •
   This difeafe is very common, and few patients in an ague apply
to phyficians.unlcfs in extremities. There are many cafes in which
the difeafe is very irregular, being complicated with other difeaf-
es, or attended with fymptoms which are both very dangerous and
very difficult to underftand.  All thefe we  have  purpofely pafld
over, as they would only bewilder fhe generality of readers.  When
the difeafe is very irregular, or the  fymptoms dangerous, the pa-
tient ought immediately to apply to a phyfician, and ftriaiy to fol-
low his advice.
   To prevent r.gves, people muft endeavour to avoid their caufes.
Thefe have  been already pointed out in the beginning of this feo
tion ; we fhall therefore only add one preventive medicine, which
 may be of ufe to fuch as are obliged to live  in low marfhy coun-
 tries, or who are liable to frequent attacks of this,difeafe.
   Take an ounce of the beft Peruvian bark; Virginia fnake-root,
and orange-peel, of each half an ounce; bruife them all together,
and infufe for five or fix days in a bottle of brandy, Holland-gin, or
any good fpirit;  afterwards pour off the clear liquor,  and take a
wine glafs of it twice  or thrice  a-day.  This is recommending a
dram ; but  the bitter ingredients in a great meafure take off the
ill effeas of the fpirit. Thofe who do not choofe it in brandy, may
infufe it  in  wine ; and fuch as can bring themfelves to chew the
b2rk, will find  that method fuccced very well.   Gentian root, or
calamus aromaticus may alfo be chewed by turn$ for the fame pur-
pofe. Ail bitters feem to be antidotes to agues efpecially thofe that
;are warm and aftringent.
                CHAPTER   XV.

              Of an  Acute  Continual Fever.

     THIS fever is termed acute, ardent, or inflammatory. It moft
      commonly attacks the young, or perfons about the prime or
vigour of life, efpecially fuch as live high, abound with blood, and
whofe fibres are ftrong and elaftic.  It feizes people at all feafons
of the year ; but is moft frequent in the fpring and  beginning of
fummer.           '
   CAUSES.----An ardent fever may be occafioned by any thing
that overheats the body, or produces plethora, as violent ex-Tcife,
fleeping in the fun, drinking ftrong liquors, eating fpiceries, a full '
diet,  with little exercife, &c.  It may likewife be occafioned by 
      OF AN ACUTE CONTINUAL FEVER.     11§

whatever obftruas the perfpiration, as lying on the damp ground,
drinking cold liquor when the body is hot, night watching, or the
like.                                                  "   '■
   SYMPTOMS.——A rigour or  chillnefs generally  ufliers in
this fever, which is loon fucceeded by great heat, a frequent and
full pulfe, pain of the head* dry fkin, rednefs of the eyes, a florid
countenance,  p'-uns hi* the back, loins, &c. To thefe fucceed dif-
ficulty of breatLitrj;, ficknefs, with an inclination to vomit. The
patient complains of great third, has no appetite for folid food, is
relllefs, and his tongue  generally appears black and rough.
   A delirium, exceffive  reftleflnefs, great oppreffion of the breaft,
with laborious refpiration, ftarting of the tendons, hickough, cold
clammy  fweats, and an  involuntary difeharge of urine, are very
dangerous fymptoms.
   As this difeafe is always attended with  danger, the beft medi-
cal affiftance ought to be procured as foon as poffible. A phyfician
may be of  ufe at the beginning,  but his fkill is often of no avail
afterwards. Nothing can be more unaccountable than the condua
of thofe who have  it in  their power,  at  the beginning of a fever,
to procure the beft medical  adiftance,  yet put it off till things
come to  an extremity. When the difeafe, by delay or wrong treat-
ment, has  become  incurable, and has  exhaufted the ftrength of '
the patient, it is in vain to hope for relief from medicine. Phyfi*
cians  may indeed  afiift Nature ; but  their  attempts muft ever
prove fruitlefs, when fhe is no longer able to co-operate with their
endeavours.
   REGIMEN.----From the fymptoms of this difeafe, it is evi-
dent, that "the bloo.: and other humours require to be diluted ;
that the perfpiration, Urine, faliva, and all the other fecretions, are
in too fmall quantity ; that  the veffels are rigid,  and the heat of
the whole body too  great: all thefe clearly point out the neceffity
of a regimen calculated  _to dilute  the blood,  allay the  exceffive
heat, remove the fpafmodic ftriauie of the veffels, and promote
the fecretions.
   Thefe important purpofes may be greatly promoted by drinking
plentifully  of diluting liquors ; as water-gruel,  or oatmeal-tea,
clear whey, barley-water, balm-tea, apple-cea, &c. Thefe maybe
iharpened with juice of  orange, jelly  of currants, rafpberries, and
fuch-like : orange-whey is likewife an excellent cooling drink. It
is made by boiling among milk and water a bitter orange fliced,
till the curd feparates.  If no orange can be had, a lemon, a little
cream of tartar, or a few fpoonfals of vinegar, will have the fame
effea.  Two or three fpoonfuls. of white wine may be occafionaily
added to the liquor  when boiling.
  If the patient be coftive, an ounce of tamarinds, wirh two ounces
of Honed raifins of the fun, and a couple of figs, may be boiled in
three Englifh pints of water  to a quart.  This makes a very  pfea-
fant drink, and may bi ufed at difererioa.  'ilh: comrtioa pectoral 
120    OF AN ACUTE CONTINUAL FEVER.
decoaion is likewife a very proper drink in this difeafe.  A tea-
cupful of it may be taken every two hours, or oftener, if the pa-
tient's heat and thirft be very great*.
  The above liquids muft all be drank a little warm.  They may
be ufed in fmaller quantities at the beginning of a fever, but more
freely afterwards, in order to affift in carrying off the difeafe, by
promoting the different excretions.  We have mentioned a variety
of drinks, that the patient may have it in his power to choofe
thofe which are moft agreeable  ; and that, when tired of one, he
may have recourfe to another.
  The patient's  diet  muft be very fpare and light.  All forts of ,
fiefh-meats, and even chicken-broths, are to be avoided.  He may
be allowed groat-gruel, panado, or light-bread boiled in water; to
which may be added a few  grains of common fait,  and a  little
fugar, which will render it more palatable.  He may eat roafted
apples with a little fugar, toafted bread with jelly  of currants,
boiled prunes, &c.
   It will greatly relieve the patient, efpecially in  an hot feafon,
to have frefh air frequently let  into his chamber.   This muft al-
ways be done in fuch a manner as not to endanger his catching
cold.
   It is too common in fevers to load the patient with bed-clothes,
under the pretence of making him fweat, or defending him from
the cold. This cuftom has many ill effeas. It increafes the heat
of the body, fatigues the patient, and retards, inftead of promoting,
the perfpiration.
   Sitting up-right in bed, if the patient is able to bear it, will of-
ten have a good effea.  It relieves the head, by retarding the mo-
tion of the blood to the brain.   But this pofture ought never to be
continued too long :  and if the patient is inclined to fweat,  it will
be more fafe to  let him lie,  only raifing his head a little with pil-
lows.
   Sprinkling the chamber with vinegar, juice of lemon, or vinegar
and rofe-water, with a little nitre diflblved in it, will greatly re-
frefh the patient.  This ought to be done frequently, efpecially  if
the weather is hot,
   The patient's mouth fhould  be often wafhed with a mixture 6f
water a«d honey, to which a little vinegar may be added ; or with
a decoaion of figs in barley-water.  His feet and hands ought fre-
quently to be bathed in lukewarm water ;  efpecially if the head is
affeaed.
   The patient fhould be  kept as quiet and eafy as poffible.  Com-
pany, noife,  and every thing that difturbs the  mind, is hurtful.
Even too much light, or any thing that affeas the fenfes, ought to be
avoided.  His attendants  fhould be as few as poffvble, and they
ought not to be too often changed.  His inclinations fliould rather

            , * See Appendix, Peroral Decoftion. 
       OF AN ACUTE CONTINUAL FEVER,  jjm

be foothed than contradiaed ; even the promife of what he craves
will often fatisfy him as much as its reality.
   MEDICINE.----In all this and other fevers, attended with a
hard, full, quick pulfe, bleeding is  of the greateft importance.
This operacion ought always to be performed as foon as the fymp-
toms of an inflammatory fever appear. The  quantity of blood to
be taken away, however, muft be in proportion to the ftrength of
the patient and the violence of the difeafe.  If, after the firft bleed-
ing the fever fhould rife, and the pulfe become more frequent and
hard, there will be a neceffity  for repeating it a fecond,  and per-
haps a third, or even a fourth time, which may be done at the dif-
tance of twelve, eighteen, or twenty-four hours from each other,
as the fymptoms require*. If the heat and fever be very great, forty
or fifty drops  of the dulcified or fweet fpirit of nitre may be made
into a draught, with an ounce of rofe-water, two ounces of com-
mon water, and half an ounce of fimple fyru^, or a bit of loaf-fu-
t^ir. This  draught may be given to the patient every three or four
hours while the fever is violent; afterwards once in five or fix
hours will be fufficient.
   If the patient be afiliaed  with reaching, or an inclination to
 vomit,  it will  be right to affift Nature's attempts,  by  giving him
 weak camomile-tea, or lukewarm water to drink.
   If the body be bound, a clyfter of milk and water, with a little
 fait, and a fpoonful of fweet-oil or frefh butter in it, ought daily to
 be adminiftered.  Should this not have the defired effea,  a tea-
 fpoonful of magnefia alba,  or cream of tartar, may be frequently
 put into his drink. He may likewife eat tamarinds, b6iled prunes,
 roafted apples, and the like.
   If about the tenth, eleventh, or twelfth day, the pulfe becomes
 more foft, the tongue moifter,  and  the urine begins to let fall a
 reddifh fettlement, there is reafon to expea a favourable iflue to
 the difeafe. But if, inftead  of thefe fymptoms, the patient's fpirits
 grow languid, his pulfe finks, and his breathing becomes difficult,
 with a ftupor, trembling of the nerves, flarting of the tendons, &c.
 there is reafon to fear that the confequences will be fatal. In this
 cafe, blifters muft be applied  to the head, ancles, infideof the legs
 or thighs, as there  may  be occafion;  poultices  of wheat-bred,
 milliard, and vinegar, may likewife  be applied to  the foles of the
 feet, and the patient muft  be fupported with cordials, as  ftrong
 wine-whey, negus, fago-gruel with wine m it, and fuch like.
    A proper regimen is not only neceffary  during the  fever, but
 likewife after the  patient  begins to recover. By  negfeaing this,
 many relapfe, or fall into other difeafes, and continue valetudinary
 for life. Though the body is weak after a fever, yet the diet for
' fome time ought to b~. rather cleanfing than of too nourifhing a

    -* Dnriogthe time bleedings are employed, brisk purging with g'au-
 ber falts fhcui'd hot be omitted.  (I- C )
                               Q 
                  OF THE PLEURISY.

nature. Too much food,drink, exercife, company, Sec. are careful-
ly to be avoided.  The mind  ought to be kept eafy, and the patient
fliould not purfue  fludy, or any  bufinefs that requires  intenfe
thinking.
   If the digeftion is bad, or the patient feized at times with f verifh
heats,  an infufion  of bark in cold water wiil be of ufe..  It wili
flrength.cn the ftomach, and help to fubdue the remains cf the fever.
   When the patient's ftrength is pretty well recovered, he ought
to take fome gentle laxative.  An ounce of  tamarinds and  a dram
of fen a may be boiled for a few minutes in an Englifh pint of wa-
ter, and an ounce of manna dilfolved in the decoaion ; afterwards
it  may be drained,  and a tea-cupful drank every hour till it ope-
rates. This dofe may be repeated twice or thrice, five.or fix days
intervening betwixt each  dofe.
   Thofe who follow  laborious employments ought not to return
too ft on to their labour after a fever, but fhould keep eafy till their
ftrength and fpirits are fuiFiciently recruited.
                 C  H A P T E-R   XVI.

                     .  Of the Pleurify..

     THE the pleurify is an inflammation of  that membrarree  cal-
      led the pleura,  which lines the infide of the breaft.  It is c'if-
tinguifhed into the moift and dry. In the former, the patient fpits  -
freely; in  the latter,  little, or none at  ail.  There is likewife a
fpecies of this difeafe, which is called thefpurious or l c/iard pleurify,
In which the pain is more external, and chiefly affeas the mufcles  '
between the ribs. The pleurify prevails among labouring people,
efpecially fuch as work without doors, and are of a fanguine con-
ftitution. It is moft frequent in the fpring feafon.
   CAUSES.----The pleurify may be occafioned  by  whatever
obftruas the perfpiration ; as cold northerly winds ; drinking cold
liquors when the body is hot ; fleeping without-doors on the damp
ground ; wet  clothes ; plunging the body into  cold water, or e&-
pofing it to the cold  air, when covered  with fweat, Sec.  It may
be occafioned by drinking ftrong liquors ; by the floppage of ufual
evacuations ;  as old  ulcers, iffues<, fweating  of the feet or hands,
Sic.  the  fudden finking in  of any eruption, as the itch,  the men-
lies,  or the fmall-pox. Thofe  who have been accuftomed to bleed
at a  certain feafon of the  year, are apt, if they r.egfea it, to be
feized with a pfeurify. Keeping the body too warm by means of
fire,  clothes, c\c. renders it  more liable to this difeafe.  A pleurify
may  likewife  be occafioned by violent exercife, as running, wreft-
ling, leaping, or by fupporting gr.eat weight, blows ori the breaft,  ■ 
                    OF THE PLEURISY.             123

  Bee.  A bad comiormationof the body renders perfons more liable
  to this difeafe, fuch as a narrow cheft, &c.
     SYMPTOMS.----This, like mofl other fevers, generally begins
  with chilfinefs antffhivering,  which are followed by heat,~ thirft,
  and reftlelfnefs.  To thefe fucceeds a violent pricking pain in one
  of the fides among the ribs*. Sometimes the pain extends towards
  the back-bont, fometimes towards the forepart of the breaft, and at
  other times towards  the fhouldeT' blades.. The pain  is generally
  moft violent when the patient draws in his breath.
     The pulfe in this difeafe is commonly-quick and hard, the urine
  ■high-coloured; and.if blood  be let, it is covered  with  a tough
  cruft, or buffy coat.  The patient's fpittle  is at firft thin, but after-
  wards it becomes grofler, and is qften ftreaked with blood.
     REGIMEN.----Nature generally endeavours to carry off this
  ■difi-afe by a critical difeharge of blood from fome part of the body,
  by expectoration, f,.  eat, loofe Roots, thick urine, or the like.  We
  ought therefore to fecond her intentions  by leffening  the force of
  •the circulation ; relaxing the veffels,  diluting the  humours,  and
  promoting expeaoration.
     For thefe purpofes, the diet, as in the former difeafe. ought to be
  cool, flender and dilating.  The patient muft avoid  all food that is
  vifcid, hard of digeftion, or that affords  much naurifhment; as
  flefh, butter, clieefe,  eggs,  milk, and every filing that is of a heat-
  ing nature. HLs drink may be whey, or an infufion of peaoral and
  balfimic vegetables;-.                                  r
     Barley-water, with a little honey -or jelly of currants mixed with
  it, is a very proper drink  in this difeafe.  It is made by boiling aw
  ounce of peari-haricy in  three Englifh  pints of wate^r to two,
>  which muft afterwards beilrained. The decoaion of  figs, raifinp,
  barie?, recommended hi the preceding difeafe, is here very proper.
  Thefe and other diluting liquors are not to be drank in large .quan-
  tities at a time, but the patient  ought to  keep continually hoping
  them, fo as to render his mouth and throat always moift.  All his
  food and drink fhouldbe taken a little warm.
     The patient fhould be kept quiet, cool, and  every way  eafy, as
  idireacd under the foregoing difeafe.   His feet and hands ought
  daily to be bathed in lukewarm  water; and he may fometimes fit
  up in bed for  a fhort  fpace to relieve his head.
     MEDICINE.——Almoft every perfoi-i knows, when a fever is
  attended vv ith a violent pain of  the .fide,  and a quick hard pulfe,
  that bleeding is neceffary.   When thefe fymptoms come  on,  the
  fooner this operation is performed  the better; and the  quantity
  at iirtl muft be pretty large if the patient is able to bear it.  A lafge
  quantity of blood let at once, in the beginning of a pleurily,  has
  a much better effea than repeated fmall bleedings.  A man may

    •K  Iii fome cafes of pleurify, the pricking pain in the fldeprecedes the
  .cmllinefs and fliivering.  (I. C.)
                 .j  S<.e Appendix, Tecloral  infufion, 
124             OF THE  PLEURISY.

lofe twelve or fourteen ounces of blood as foon as it is certainly
known that he is feized with a pleurify. For a younger perfon, or
one»of a delicate conftitution, the quantity muft be lefs.          i
  If, after the  firft bleeding,  the flitch,  with the other violent /
fymptoms, fhould ftill continue, it will be rieceflary, at the diftance
of twelve or eighteen hours, to let eight or nine ounces more. Jf
the fymptoms do not then abate, and the blood fhow-s a ftrong huffy
coat, a third, or even a fourth bleeding may be requifite.  If the
pain of the fide abates, the pulfe becomes  fefter, or the patient
begins to fpit freely, bleeding ought not to be repeated. This opera-
tion is feldom neceffary after the third or fourth day of  the fever,
and ought not then to be performed,  unlefs in the moft urgent cir-
cumftances.
  Topical bleeding'has often a verygood effea in this difeafe. It
may be  performed ."by applying a number of leeches to the part
affeaed, or by cupping, which is a more cert; in and expeditious
method.
   If the flitch  continues after repeated bleedings, a blifter muft
be applied over the  part affeaed. This not only  procures a dif-
eharge from the fide, but takes off the fpafm, and by that means
affifts in removing the caufe of the difeafe.  To prevent a ftrangury
wdien the blifter is on, the patient may drink freely of the Arabic .,
emulfion * or flax-feed»tea. .
   If the patient is coftive, a clyfter of thin Water-gruel, or of barley-
water, in which a handful of mallows, or any other emollient ve-
getable has been boiled, may be daily adminiftered. This will not  <
only empty the bowels, but have the effea of a warm fomentation
applied to the inferior vifcera, which will help to make a deriva-
tion from the breaft.
   The expeaoration or fpitting may be promoted by fliarp,  oily,
and mucilaginous medicines.  For this purpofe,  an ounce cf the
oxymel, or the vinegar of fquills,  may be added to fix  ounces of
the peaoral decoaion, and two table-fpoonfuls of it taken  every
two hours.
   Should the fquill difagree with the ftomach,  the oily emulfion
 may be adminifteredf ;  or, in place of it, two ounces of the oil of
fweet-almonds, or oil of olives, and two ounces of the fyrup of  '
violets may be mixed with as much fugar-candy powdered, as will
make an eleauary of the confiitcn.ee of honey.  The patient may
take a tea-fpoonful  of this frequently, when the cough  is trouble- J
fome. Should oily medicines prove naufeous, which is  fometimes 1
 the cafe, two table-fpoonfuls of the folution of gum-ammoniac in
barley-water may be given three or four times a-d ay§.
   If the  patient does not perfpire, but has a burning  heat upon
 his fkin, and pafles very little water, fome fmall dofes of purified  J

   .* See Appendix, Arabic Emtilfion.
   + See Appendix, Oily Emulfion.
   5 See Appendix, Solution of Gum- Ammonia^. 
OF  THE PLEURISY.
125
nitre  and camphire will be of  ufe.  Two drams of the former
may be rubbed with five or fix grains of the latter in  a mortar,
and the whole divided into  fix dofes,  one of which may be taken
every five or fix hours, in a little of the patient's ordinary drink.
.   There is one medicine which fome reckon almoft  a  fpecific in
the pleurify, viz. the decoaion  of the Seneka rattle-fnake root*.
After bleeding and other evacuations  have been premifed, the pa-
tient may take two, three, or four table-fpoonfuls qf this  decoc-
tion, according as his ftomach will bear it, three or four times a-
day. If it fhould occafion vomiting, two of three ounces of fimple
cinnamon-water may be mixed with the quantityof decoaion here
dircaed, or it may be taken in  fmaller dofes.  As this medicine
promotes perfpiration and urine, and likewife keeps the  body eafy,
it may be of fome fervice in a pleurify, or any other inflammation
of the breaft.
   No one will imagine that thefe medicines are all to  be ufed at
the fame time.  We have mentioned  different things, on purpofe
that people  may have it in  their power to  choofe;  and likewife,
that when one cannot be obtained, they may make ufe of another.
Different medicines are no doubt neceffary in the different periods
of a diforder ; and  where one fails of fuccefs, or difagrees with
the patient, it will be proper to try another.
   What is called the crifis, or height of the fever, is fometimes at-
tended with very alarming  fymptoms ; as difficulty of  breathing,
an irregular pulfe,  convulfive motions, Sec.   Thefe are apt to
frighten the attendants, and induce them to do improper things,
as bleeding the patient,  giving him ftrong ftimulating medicines,
or the like. But they are only the ftruggles of Nature  to overcome
the difeafe, in which fhe ought to be alfifted by plenty of diluting
drink, which is then peculiarly neceflary. If the patient's ftrength,
however, be much exhaufted by the difeafe, it will be neceffary at
this  time to fupport him with frequent fmall draughts of  wine-
whey, negus, or the like.
   When  the pain and  fever are gone, it will be proper, after the
patient has recovered fufficient ftrength, to  give him fome gentle
purges, as thofe direaed towards  the end of the acute continual
fever.  He ought likewife to ufe a light diet, of eafy digeftion, and
his drink fliould be butter-miik, whey, and other things of a cleanf-
jng nature.
             The Baflard or Spurious Pleurify

   GENERALLY goes  off by  keeping warm  for a few days,
drinking plenty of diluting liquors, and obferving a cooling re-
gimen.  It is known by a dry cough, a quick pulie, and a difficulty

            *f See .Appendix, Deco.Vion offeueka root. 
I26           OF A  PERIPNEUMONY.

of lying on the affected fide, which la ft does not always happen
in the true pleurify.  Sometimes indeed this difeafe proves  obfli-
nate, and  requires bleedihg, with cupping,  and fearifications of
the part affeaed.  Thefe, together with the ufe of nitrous and
ether cooling medicines, feldom fail to effect a cure.
                    The Paraphrenias,

  OR inflammation of the diaphragm, is fo nearly comieaed with
The pleurify, and refembles it fo much in the manner of treatment,
chat it is fcarce rfeceflary >to confider it as a fepar-Ue difeafe.
  It is attended with  a very acute fever, and an extreme pain in
the part affeaed,  which is  generally  augmented  by coughing,
freezing, drawing in the breath, taking food,  going to flool, mak-
ing water, Sec.  Hence the patient breathes  quick, and  draws in
Iiis bowels  to prevent the motion of the diaphragm; is reftlefs,
anxious, has a dry cough, a hickough and often a delirium. A con-
vulfive laugh, or a kind of involuntary grin, is a common fymptopa
of this difeafe.
   Every method muft be taken to prevent a fuppuration, as it is
impoflible to fave the  patient's life when this happens. The regi-
men and medicine are in all  refpeas the fame as in the pleurify.
Emollient clyfters are peculiarly ufeful, as they relax  the bowels,
and  by  that means make a derivation from the part affeaed.
               CHAPTER   XVII.

     Of a Peripneumony or Inflammation of the Lungs.

     AS this difeafe affeas an organ which is abfolutely neceffary to
      life, it is always attended with danger. Perfons who abound
with blood, whofe fibres are ten(e and rigid, who feed upon grofs
aliment, and drink ftrong vifeid liquors, are moft liable to a perip-
neumony.  It is generally fatal to thofe who have a flat breaft, cr
narrow cheft, and to fuch as are afiliaed with an afthma, efpecial-
ly in the decline of life. Sometimes the inflammation reaches to
one lobe of the lungs only, at other times the  whole of the organ
is affeaed ; in which cafe the difeafe can hardly fail to prove facal.
  When the difeafe proceeds from  a vifeid matter obftruaing the
veffels of  the lungs, it is called -dfpurious or bajlard peripneumony. A
When it arifes from a thin acrid defluxion on the lungs, it is de- Jj
nominated a catarrhal peripneumony, Lee.
  CAUSES.----An  inflammation of the  lungs is  fometimes  a
primary difeafe, and fometimes it Is .the confequence of other dif- 
OF  A PERIPNEUMONY.
127*
eafes, as a quinfey, a pleurify ,i&c. It proceeds from the fame caufes
as the pleurify, viz.  an obftruaed perfpiration  from cold, wet
clothes, &c. or from an increafed circulation of the blood, by vio-
lent exercife, the ufe of fpiceries, ardent fpirits, and .uch like.  The
pleurify and peripneumony are often complicated ; ia which cafe
the difeafe is called apir.tr-ipcr ipneumony.
   SYMP TOMS.----Moll of the fymptoms of a pleurify likewife
attend an inflammation of the lungs ;  only  in  the latter the pulfe
is more foft and the pain lefs acute ; but the difficulty of breathing,
and oppr^fiion of the breaft,  are generally greater.
   REGIMEN-.----The regimen and medicine are in all refpeas
the fame in the true  peripneumony as in the pleurify, the aliment
ought to be more flender and thin in  this than in any other inflam-
matory difeafe.  Dr.  Arbuthnot afferts, that even common whey-
is fufficient to fupport the p itiem, and that decoaions of  barley,
and infufions of fennel roots in warm  water with milk, are the moft
proper both for drink and nouriihmeut. He recommends the fleam
of warm water takrn i.i by the breath, which ferves  as a kind of
internal  fomentation, and  nelps to  attenuate the impaaed  hu-
.mours. If the patient has loofe llools, but is not weakened by them,
they  are vot  to  L-s  flopped, but rather  promoted by emollient
ci'^ite it
   T'-.: ([arizus or bajlard peripneumony is occafioned by a vifeid
rna:i\.r  obftruaing the veffels of the lungs. It commonly attacks
the old, infirm, and phlegmatic,  in \i inter or wet feafons.
   The patient at the beginning is cold and hot by burns, has a fmall
quick pulfe, feels a fenfe of weight upon his breaft, breathes with
difficulty, and fometimes complains of a pain and giddinefs of his
head. His urine is ufually pale, and his colour very little changed.
   The diet in this, as well  as in  the  true peripneumony, muft be
very flender, as weak broths, fharpened with the juice of orange
or lemon, and fuch-like. His drink may be thin water-gruel fweet-
ened with  honey, or a decoaion of the roots of fennel, liquorice,
and quick  grafs.  An ounce of each of thefe may be boiled in three
Engliih pints  of water to a quart, and fharpened  with a little cur-
rant jelly, or the like.
   Bleeding and purging are  generally proper at  the beginning of
this difeafe; but if the patient's  fpitcle is  pretty thick, neither of
them are  neceffiuy.  It will be fufficient to affift the expeaoratioa
by fome of the fharp medicines recommended for that purpofe in
the pleurify, as the folutipn of  gum ammoniac with oxymel of
fquills, &c. Bliftershave generally a good effea, and ought to be
applied pretty early*.
   If the patient does  not fpit, he muft be bled according as his
ftrength will permit, and have a gentle purge admitiiftered.  Af-

   # Previous  to the application of biifters, eiipping-glafies fliould be  /
applied to  the painful part, which generally afford conliderable re-
lief,    (i.e.) 
128           OF  CONSUMPTIONS.

terwards his body muft be kept open with clyflers, and the expecto-
ration promoted,  by taking every four Louis two table-fpoonfuls
of the foiution mentioned above.
  When an inflammation of the breaft does not yield to bleeding,
bliftering, and other evacuations, it commonly ends in a fuppura-
tion, which is more or lefs dangerous, according to the part where-'
it is fituated.  When this happens in the pleura, it fometimes breaks
outwardly, and the matter is difcharged  by the Wound.
  When.the fuppuration happens within the fubilance or body of
the lungs, the matter  may be  difcharged by  expeaoration; but if
the matter floats in the cavity  of the breaft, between the pleura and
the lungs,  it can only be difcharged  by an incision made betwixt
the ribs.
  If the patient's ftrength does not return after the inflammation
is to all appearance removed ; if his  pulfe continues quick though
foft, his breathing difficult and oppreffed ; if he has cold fhiveringj
at times, his cheeks flufhed, his lips  dry ; and if he complains of
thirft, and  want of appetite,  there is reafon to fear a fuppuration,
and that a  phthifis or confumption of the lungs v/ill enfue*.  We
fhall therefore next proceed  to confider the proper treatment of
that difeafe.
               CHAPTER   XVIII.

                      Of  Confumptions.

      ACOMSUMPTION is a wafting or decay of the whole bo-.,
       dy from an ulcer, tubercles, or concretions of the lungs, an ,
empyema, an atrophy, or a cachexy.
  Dr.  Arbuthnot obferves,  that in his time  confumptions made
up above one-tenth part of the bills of mortality in and about
London.  There is reafon  to believe they  have rather increafed
fince ;  and we know from experience,  that they are not lefs fatal
in fome other towns of England than in London.
  Young perfons, betwixt die age of fifteen and thirty, of a lien-:
der make, long neck, high fhoulders, and flat breafts, are mofthV
ble to this difeafe.
  Confumptions prevail more in England, than in any other part,
of the world, owing perhaps to the great ufe cf animal  food and,
malt liquors, the general application.to fedentary employments,

  -* In cafes of this kind, where feveral qu.-irts of pus or matter ban
been difcharged from the mouth, the patient has been lecoveredby vefk
ding, during fpring awl fummer,.in the country,' affifted by a nonrifoiq
diet, exercife on horfe-back, and the extract cf bark.  (J. C ) 
                OF  CONSUMPTIONS.              129

and the great quantity of pit-coal which is there burnt; to which
we may add the perpetual changes in the atmofphere, or variable-
nefs of the weather.
  CAUSES.----It has  already been obferved, that an inflamma-
tion in the breaft often  ends in an impoflhume:  Consequently,
whatever difpofes people to this difeafe, muft likewife be confi-
dered as a caufe of confumptions.
  Other difeafes, by vitiating the habit, may likewife  ccafon  con-
fumptions; as the feurvy, the ferophula,  or king's evil, the vene-
real difeafe, the afthma,  fmall-pox, mealies, &c.
  As this difeafe is feldom cured, we fhall endeavour the more
particularly to point out its caufes, in order that people may be ena-
bled to avoid it., Thefe are :
  -----Confined or unwholefome,air.  When this fluid is impreg-
nated with the fumes of metals or minerals, it proves extremely
hurtful to the lungs, and often corrodes the tender veffels of that
neceffary organ.
  -----Violent paffions, exertions, or affeaions of the mind; as
grief, difappointment, anxiety, or clofe application to the ftudy of
abftrufe arts orfciences.
  -----Great  evacuations ; as fweating, diarrhoeas, diabetes, ex-
ceffive venery, the fluor  albus, an over difeharge of the menftrual
flux, giving fuck too long, &c.
   -----The fudden floppage of cuftomary evacuations; as the
bleeding  piles, fweating of  the  feet, bleeding at the  nofe, the
menfes, ifl'ues, ulcers, or eruptions of any kind.
  -----Injuries done to the lungs, calculi,  &c.  1 lately faw the
fymptoms of a phthifis occafioned by  a fmall bone  flicking in the
broncha.  It was afterwards vomited along with a corifiderable quan-
tity of purulent matter, and the patient, by a proper regimen, and
the ufe of the  Peruvian bark, recovered.
   _____Making a fudden tranfition from a hot to a very cold cli-
mate, change of apparel, or whatever greatly leffensdie perfpiration.
  '-----Frequent and exceffive debaucheries.  Late watching, and
drinking ftrong liquors, which generally go  together, can hardly
fail to deftroy the lungs. Hence, the ban companion generally falls
a facrifice to this difeafe.
   -----Infeaion.  It is fufpicious that Confumptions are caught
by  fleeping with the difeafed ; for which reafon, this fliould be
carefully avoided.  It cannot be of great benefit to the fick, and muft
hurt thofe in health.
  -----Occupations in life. Thofe artificers who fit much, and are
conftantly leaning forward,  or  preffing upon  the ftomach and
breaft, as cutlers; taylors, fhoe-makers, feamftreffes, &c. often die
of  confumptions. They likewife prove fatal to fingers, and all who
have occafion to make frequent and violent exertions of the lungs.
   -----Cold.  More confumptive patient^ date the beginning of
 their diforders from wet feet, damp  beds, night air, wet clothes,
                             R 
13©
OF  CONSUMPTIONS.
    or catching cold after the body had been  heated, than from all
    other caufes.
      Sharp, faline, and aromatic aliments, which heat and inflame   ••
    die  blood, are likewife frequently the caufe of confumptions.
      We fhall only add,that this difeafe is often owing to an heredita-
    ry faint, or a ferophulous habit; in which cafe it  is generally  in-
    curable.
      SYMPTOMS.----This difeafe generally begins with  a dry
    coughjwhich oftencontinuesforfome months. If a difpofition to vo-
    mit after eating be excited by it, there is ftill greater reafon to fear
    an approaching confumption.  The patient complains of a more
    than ufual degree of heat, a pain and oppreffion of the breaft, ef-
    pecially after motion ; his fpittle is of a faltifh tafte, and fometimes
    mixed with blood. He is apt to be fad ;  his appetite is bad, and his
    thirft great. There is generally a quick, foft, fmall pulfe; though    ;
    fometimes  the pulfe is pretty full, and rather hard.  Thefe are the
    common fymptoms of a beginning confumption.
      Afterwards the patient begins to fpit  a greenifh, white, or bloo-
    dy matter. His body is extenuated by the heaic  fever, and colli-
    quative fweats, which mutually fucceed one another, viz. the one
    towards night, and the other in the morning. A loofenefs, and an
    exceffive difeharge of urine, are  often troublefome fymptoms at
    this time, and greatly weaken the patient. There  is a burning heat
    in the palms of the hands, and the face generally  flufhes after eat-
    ing ; the fingers become remarkably fmall,  the nails are bent in-
(    wards, and the hairs fall off.
     -At laft the fwelling of the feet and legs/the total lofs of ftrength,
    the finking of the eyes, the difficulty of fwallowing, and the cold-
    nefs of the extremities,  fhow  the immediate approach of death,
    which the patient feldom believes to be fo near.  Such  is the  ufu-
    al progrefs of thijs difeafe, which, if not early checked, commonly
    fets  all medicine at defiance.
      &EGIMEN.----On the  firft appearance of a confumption, if
    the patient lives in a large town, or any place where the air is con-
    fined, he  ought immediately to quit it, and to make choice of
    a fituation in the country, where the air is pure and free. Here he
    muft not remain inaaive, but take every day as much exercife as he
    Can  bear.
      The beft method of taking  exercife  is to ride  on horfeback, as.
    this gives the body a great deal of motion  without much fatigue.
    Such as cannot bear this kind of exercife, muft make ufe of a carri-
    age.  A long journey,  as it amufes the mind by a continual change  ,'
    of objeas, is greatly preferable to riding the fame  ground over and
    over.  Care however  muft be* taken  to avoid catching cold from
    wet clothes* damp beds, or the like.  The patient ought always to
    finifh his ride in die morning, or at leaft before dinner ; other wife '
    it will oftener do harm than good.
      It  is a pity that thofe who attend the fick feldom recommend 
OF  CONSUMPTIONS.
l3l
  riding in this difeafe, till the patient is either unable to bear it, or
  the malady has become incurable. Patients are likewife apt to tri-
  fle with every thing that is in their own power.  They  cannot fee
  how one of the common aaion3  of life fhould prove a remedy in
  an obflinate difeafe, and therefore theysrejecc it, while they gree-
  dily hunt after relief from* medicine, merely becaufe they do not
  underftand it.                                           %
    Thofe who  have  ftrength and courage to undertake a pretty
  long voyage, may expea great advantage from it.  This, to my
  knowledge,  has frequently cured a confumption after  the patient
  was, to all  appearance, far advanced in that difeafe, and  where me-
  dicine had proved ineffeaual. Hence it is reafonable to conclude,
  that if a voyage were undertaken in due time, it would  feldom fail
  to perform a cure*.
    Such as try this method of cure ought to  carry as much frefh
  provifions  along with them as will ferve the whole time they arc
'  at: fea. As  milk is not eafily obtained in this  fituation, they  ought
  to live upon  fruits, rye and Indian mufh, and the broth of chick-
  ens, or other young animals, which can be kept alive on board.
  Such voyages fhould be undertaken, if poffible, in the mildeft fea-
  fon, and towards a warmer climatef.
    Thofe who have not courage for a long voyage may  travel into
  a more fouthern climate, as the fouth  of France, Spain or Portu-
  gal ;  and if they find the air of thefe countries agree well with
  them,  they fhould continue there, at leaft tin- their health be con-
  firmed.
    Next to  proper  air and exercife, we would recommend a due
  attention to diet.   The patient fhould eat nothing that is either
  heating or  hard of digeftion, and his drink  muft be of a foft and
  cooling nature.  All  the diet ought to be calculated to nourifh and
  fupport the patient.  For this purpofe, he muft keep chiefly to the
  ufe of vegetables and milk. Milk alone  is of more value  in this dif-
  eafe than the whole materia medica.
    Afles' milk is commonly reckoned preferable to any other;  but.
  it cannot always .be  obtained;  befides, it is generally  taken in a
  very fmall  quantity;  whereas, to  produce any effeas, it ought to
  make  a confiderable part of the patient's diet.  It is hardly to  be
  expeaed,  that a  gill or two of afles' milk, drank in the fpace of

   * The greateft benefit derived to confumptive patients ingoing to fea,
  is in proportion to the time they  are on the ocean, the temperature of
  the latitude they fail in, which fhould be agreeably warm.  Therefore,
  a long voyage, commenced at an early period of this difeafe, or what
  would be  more beneficial, a continuance for ten or twelve months,
  on the ocean, a patient in fuch a fituation, with tolerable accommoda„
  tion, would in all probability efFe&  a recovery.   (I. C.)

   t Though I do not remember to have feen one inftance of a genuine
  confumption of the lungs cured by medicine, yet! have known a Weft.
  India voyage work wonders in that dreadful diforder, 
  132              OF  CONSUMPTIONS.

  twenty-four hours, fhould be able to produce any confidence
  change in the humours of an adult; and when people do not per-
  ceive its effeas foon, they lofe hope, and fo leave it off. Hence, thii
  medicine, however valuable, very feldom performs a cure. The rea-
  fon is obvious ; it  is commonly ufed too late, is taken in too fmall
  quantities, and is not duly perfifted in.
    I have known very extraordinary effeas from afles' milk in ob-
  flinate coughs, which threatened a confumption of the lungs; and
  do verily believe, if ufed at this period, that it would feldom fail;
  but if it be delayed till an ulcer is formed, which is generally the
  cafe, how can it be expeaed to fucceed ?
   Afles' milk ought to be drank, if poffible, in its natural warmth,
 and, by a grown perfon, in the quantity of half an Englifh pint at
 a time. Inftead of taking this quantity night and morning only,
 the patient ought to take it four times, or at leaft thrice a-day, and
 to eat a little light  bread along with it,' fo as to make it a kind of
 meal.
   If. the milk fhould happen  to purge, it may be mixed with old
 conferve of rofes.  When that cannot be obtained, the powder  of
 crabs' claws may be ufed in its flead. Afles' milk is ufually ordered
 to be drank warm in bed; but as it  generally throws the  patient
 into a fweat when taken  in this way, it would perhaps be better to
 give it after he rifes.
   Some extraordinary cures in comfumptive cafes have been per-
 formed by women's milk.  Could this be obtained in fufficient quan-
 tity, we would recommend it in preference to any other. It is better
 if the. patient can fuck it from the breaft, than to drink it  after-
 wards.  I knew a man who was reduced to fuch a degree of weak-
 nefs in a confumption, as not to be able to turn himfelf in bed.
 His wife was at that time giving fuck, and the ehild  happening to
 die, he fucked her breafts, not with a view to reap any advantage
 from the milk, but to make her eafy. Finding himfelf greatly bene-
 fited by it, he continued  to fuck  her till he became perfeaiy well,
 and is at prefent a ftrong and healthy man.
   Some prefer butter-milk ;  it is a very valuable medicine if the
 ftomach be able to bear it. It- does  not agree with every perfon  at
 firil; and is often laid afide without a fufficient trial. It fhould  at
 firft be taken fparingly, and the quantiiy gradually increafed, until
 it comes to be almoft the  fole food.  I  never knew it fucceed unlefs
 where the patient almoft  lived  upon it.
   Cows' milk is moft readily obtained of any, and though it be not
 fo eafily digefted as  that of afles' or mares', it may be rendered ligh-
 ter by adding to it an equal quantity  of barley-water, or allowing
 it to fland for fome hours, and afterwards taking off the cream.
If it fhould, notwithftanding, prove heavy on the ftomach,  a fmall
 quantity of brandy  or rum, with a little fugar, may be added,
 which will render it both more light and nourifhing.
   Milk may for fome time difagree with a ftomach that has not 
                OF CONSUMPTIONS.             j_33

been accuftomed to digeft any thing but flefh and ftrong liquors,
which is the cafe with many of thofe who fall into confumptions.
We do not however advife thofe who have been accuftomed to
animal food and ftrong liquors, to leave them off all at once. This
might be dangerous. It will be neceffary for fuch to eat a littfe
once a day of the flefh of fome young animal, or rather to ufe the
broth made of chickens, veal, lamb, or fuch-like. They ought like-
wife to drink a little wine made into negus, or diluted with twice
or thriee its quantity of water, and to make it gradually weaker
till they can leave it off altogether.
   Thefe muft  he ufed only as preparatives to  a diet confifting
chiefly of milk and vegetables, which the fooner that the patient
can be brought to  bear, the better.  Rice and milk or barley and
milk, boiled with a little fugar, make very proper food. Ripe fruits
roafted, baked, or boiled, are likewife proper,  as goofe or currant
berry tarts, apples roafted, or boiled  in milk, &c. The jellies, con-
ferves, and preferves, &c.  of ripe fubacid fruits, ought to be eaten
plentifully, as the jelly of currants, conferve  of roles, preferved
plums, cherries, &c.
   Wholefome  air, proper exercife, and a diet confifting chiefly of
thefe and other vegetables, with milk, is  the only courfe that can
be  depended on in a beginning confumption.  If the patient has
ftrength and fufficient refolution to perfiil in this courfe,  he will
feldom  be difappointed of  a cure.
   In the populous town of Sheffield, where confumptions are very
common,  I have frequently feen confuniptive patients, who had
been fent to the country with  orders to ride, and live upon milk
and vegetables, return in a few months quite plump, and free from
any complaint.  This indeed Was not- always the cafe, efpecially
when the difeafe was hereditary, or far advanced;  but it was the
only method in which fuccefs was to be expeaed : where it failed,
I never knew medicine fucceed.
  If the patient's ftrength  and fpirits flag, he muft be fupported
by ftrong broths, jellies, and fuch-like. Some recommend fhell-fifh
in this diforder, and with fome reafon, as they are  nourifhing and
reflorative*. All the food and drink ought however to be taken in
fmall quantities, left  an overcharge  of frefh chyle fhould  opprefs
the lungs, and  too much accelerate the circulation of the blood.
  The  patient's mind ought to be  kept as eafy  and cheerful as
poffible. Confumptions are often occafioned, and always aggrava-
ted, by a melancholy cafl of mind ; for which reafon, mufic, cheer-
ful company, and every thing that infpires mirth,  are highly be-
neficial. The patient ought feldom to be left alone,  as brooding
over his calamities is fure to render them worfe.

  * I have often known perfons of a confumptive habit, where the
fymptoms were not violent, reap  great benefit from the ufe of oyflers.
They generally ate them raw, and drank the juice along with them, 
 134              OF CONSUMPTIONS.

   MEDICINE.-----Though the cure of this difeafe depends chief-
ly upon regimen and the patient's own endeavours, yet we fhall
mention a few things which may be of fervice in relieving fome
of the more violent fymptoms.
   In the f rft ftage of a  confumption, the cough may fometimes
he appeafed  by bleeding;  and the expeaoration may be promoted
by the following medicines. Take frefh fquills, gum-ammoniac,
and powdered cardamum feeds, of  each  a quarter of an ounce ;
beat them together in a mortar, and if the mafs proves too hard
for pills, a little of any kind of fyrup  may hj added to it. This
may be formed into pills  of a moderate fize, and  four or five of
them taken twice or thrice a-day, according  as the patient's flo-
mach will bear them. *
   The lac ammoniacum, or milk of gum ammonrc, as it is  called,
is likewife a proper medicine in this ftage of the difeafe.  It may
be ufed as direaed in the pleurify.
   A mixture made of equal parts of lemon-juice, fine.honey, and
fyrup of poppies, may likewife be ufed. Four ounces  of each of
thefe maybe fimmered together in a fauce-pan, over a gentle fire,
and a table-fpoonful of it taken at any time when the coughis trou-
blefome.
   It is common in this ftage of the difeafe  to load the patient's
ftomach with oily and balfamic medicines. Thefe,  inftead of re-
moving the caufe  of the difeafe,  tend rather  to  increafe it, by
heating- the blood, while they pall the appetite, relax the folids,
and prove  every way  hurtful to the patient. Whatever is ufed for
removing  the  cough, befides riding and  other  proper regimen,
ought to be medicines of a fharp and cleanfing nature ; as oxymel,
fyrup of lemon, Sec.
   Acids have  peculiarly  good effeas  in this difeafe; they  both
tend to quench the patient's thirft and  to cool the blood. The ve-
getable acids,  as apples,  oranges,  lemons, &c.  appear to  be the
moft proper. I have known patients fuck the juice of feveral le-
mons every day with manifeft advantage,  and would for this rea-
fon recommend acid vegetables to be taken in as great quantity as
die ftomach  will bear them.
  For the patient's drink, we would recommend infufions  or the
bitter plants, as ground-ivy, the leffer centaury, camomile  flowers
or water-trefoil.  Thefe infufions may be drank at pleafure. They
ftrcngthen the ftomach, promote digeftions,  and at the fame time
anfwer all the purpofes of dilution, and quench thirft much better
than things that are lufcious or fweet. But if the patient fpits blood,
He ought to  ufe, for his ordinary drink, infufions or decoaiohsof
the vulnerary roots, plants, &c*v
  There are many  other mucilaginous  plants  and feeds, of a heal-
ing and agglutinating nature, from which  depoaions or infufions
* See Appendix, Vulnerary decoction. 
                OF CONSUMPTIONS.              13-

may be prepared with the fame  intention ;  as the orches, the
quince-feed, coltsfoot, linfeed, farfeparilla, &c. Simple infufion or
boiling is all that  is neceffary, and the dofe may be at discretion.
  The conferve of rofes is here peculiarly proper. It may either
be put into the decoaion above preferibed, or eaten by itfelf. No
benefit is to be expeaed from trilling dofes of this medicine. I ne-
ver knew  it of  any fervice unlefs where  three or four ounces at
leaft were ufed daily for a conflderable  time., In  this  way I have
feen it produce  very happy etlecls, and would recommend it wher-
ever there is a difeharge of blood from the lungs.
  When the fpitting up of grofs matter, oppreflion of thcbreaft,
and the heaic' fymptoms, fhow that an impofthume is formed  in
the lungs, we would recommend the bark, to fupport the ftrength
of  the patient.
  An ounce of the bark in powder may  be divided into eighteen
or  twenty dofes,  of  which one may  be  taken every  three hours
through the day, in a little fyrup, or'a cup of horehound-tea.
  If the bark fhould happen to  purge, it may be made wito  an
efeauary, with the conferve of rofes, thus: Take old conferve of
rofes a  quarter of a pound, bark in  powder an ounce,  fyrup of
orange or  lemon, as much as will make k of the confiftence of
honey.  This quantity will ferve the patient four or five days, and
may be repeated as there is occafion.           .
  Such as cannot take  the bark in fubftance, may infufe it in cold
water. This feems to be the beft menftruum for extraaing its vir-
tues. Half an oiince of bark in powder may be infufed for twen-
ty-four hours in half an Englifh pint of water. Afterwards let it
be  paffed through a fine ftrainer, and  an ordinary tea-cupful  of
it taken three or four times a-day.
   We would not recommend the bark while  there are any fymp-
toms of an inflammation of the breaft ; but when it is certainly
known that matte* is colfeaed there, it is  one of the beft medicines
which can be ufed.  Few patients indeed have refolution enough
to  give the bark a fair trial at this period of the difeafe, otherwife
we have reafon  to believe that fome benefit might be reaped from it.
   When it is evident that there is an impofthume in the breaft,
and the matter can neither be fpit up nor  Carried  off by abforption,
die patient muft endeavour to make it break inwardly, by drawing
 in  the fleams of warm water or vinegar with his breath, coughing,
 laughing, or bawling aloud, &c When it happens to burft within
 the lungs, the matter maybe difcharged by the mouth. Sometimes
 indeed the J>urlling of the vomica occafions immediate  death, by
 fuftbcating the patient. When the quantity of matter is great, and
 die patient's ftrength exhaufled, this is commonly the cafe.  At any
 rate, he is ready to fall into a {woon, and fliould have volatile fidts
 or  fpirits held to  his njfc
   Jf the matter difchi^d be thick,.and the cough.and  breathing
 become eafier, there may be fome hopes of a  cure. The diet at 
 i ^6            OF CONSUMPTIONS.

 thiTtime ought to be light, but reftorative, as chicken-broths, fago-
 gruel, rice-milk, &c.  the drink, butter-milk, or whey, fweetened,
 with honey. This is likewife a proper time for ufing the  Peruvian
 bark, which may be taken as direaed above.
  If thevomica or impofthume fhould difeharge itfelf into the cavity
 of  the breaft, betwixt the pleura and the lungs, there is -no way of
 getting the matter out but by an incifion, as has already been ob-
 ferved. As this operation muft always be perfomed by a furgeoi,
 it  is not neceffary here to deferibe  it. We fhall  only add, that it
 is not fo dreadful as people are apt  to imagine, and that it is the
 only chance the patient in this cafe  has for his life.
   A NERVOUS CONSUMPTION, is a wafting or decay of the
 whole body, without any confiderable degree  of. fever,  cough or
 difficulty of breathing.  It is attended with indigeftion, weaknefs,
 and want of appetite, &c.
   Thofe who are of a fretful temper, who indulge in fpirituous
 liquors,  or who breathe an unwholefome air, are moft liable to
 this difeafe.
   We would chiefly recommend, for the cure of a nervous  con-
 fumption, a light  and nourifhing diet, plenty of  exercife in a free
 open air, and the ufe of  fuch  bitters as  brace  and ftrengthen the
 ftomach ; as the bark, gentian root, camomile, horehound, &o
 Thefe may be infufed in water or  wine, and a  glafs of it drank
 frequently.
   lc will greatly  affift the digeftion, and promote the cure  of this
 difeafe, to take twice a-day twenty  or thirty droops of the elixir of
 vitriol in a glafs of wine or water. The chalybeate wine is likewife
 an  excellent medicine in this cafe.  It ftrengthens the folids, and
 powerfully aflifts Nature in the preparation of good blood*.
   Agreeable amufements, cheerful company, and riding about, are
 however preferable to all medicines  in this difeafe. For which rea-
 fon, when the patient can afford it, we would recommend a long
 journey of pleafure, as the moft likely means to reftore his health.
   What is called zfymptomatic confumption cannot be cured without
 firft removing the difeafe by which it is occafioned.  Thus, when
 a comfumption proceeds from the ferophula or king's evil from the
 feurvy, the afthma,  the venereal difeafe, &c. a  due attention  muft
 be paid to the malady from whence it arifes, and the regimen and
 medicine direaed accordingly.
   When excejjive evacuations  of any kind  occafion  a   confump-
 tion, they  muft not only be reftrained,  but the  patient's ftrength
 muft be reftored  by gentle exercife, nourifliing diet, and generous
 cordials. Young and delicate mothers often fall into confumptions,
 by giving  fuck too  long.  As foon as they perceive their ftrength
 and appetite begin to fail, they ought immediately to wean the child,
, or provide another nurfe, otherwife they ^uiot expea a  cure.

                 s See Appendix, Chalybeate wine. 
            OF THE  NERVOUS  FEVER.         137

   Let all, as they v ifli to avoid confumptions, take as much exer-
cife without-doors as they can, avoid unwholefome air, and ftudy
Sobriety. Confumptions owe their prefent increafe not a little to the
fafhion  of fitting up late, eating hot Suppers, and fpending evefy
evening over a bowl of hot punch or other ftrong liquors. Thefe
liquors, when too freely ufed, not only hurt the digeftion, and fpoil
the appetite, but heat and inflame the  blood, and fet the whole
Conftitution on fire.
               CHAPTER   XIX.

              Of the Slow or Nervous Fever.

     NERVOUS fevers have increafed greatly of late yeaw in this
      country, owing, doubtlefs, to our different manner of living,
and the increafe of fedentary employments ; as they commonly
attack perfons of a weak, relaxed habit, who neglea exercife, eat
little folid food, ftudy hard, or indulge in fpirituous liquors.
   CAUSES.----Nervous fevers may be occafioned  by whatever
depreffes the fpirits, cr impoverishes the blood ; as grief, fear,
anxiety, want of fleep, intenfe thought, living en pour watery diet,
unripe fruits-, cucumbers, melons, mufhrooms, &c. They may like-
wife be occafioned by damp, confined, or unwholefome air.  Hence
they are very  common in  rainy feafons,  and prove moft fatal to
thofe who live in dirty low  houfes, crowded ftreets, hofpitals, jails,
or fuch-like places.
   Perfons whofe conftitutions have been  broken by  exceffive ve-
nery, frequent Salivations,  too free an ufe of purgative medicines,
or any other exceffive evacuations, are moft liable to this difeafe.
   Keeping on wet  clothes, lying  on the damp ground, exceffive
fatigue, and whatever obftrucls the perfpiration, or caufes a fpaf-
modic ftriaure of  the folids, may-likewife occafion nervous fe-
vers. We fhall only add^ frequent and great irregularities in diet.
Too great abftinence,as well as excefs, is hurtful.  Nothing fends fo
much to preferve the body in a found ftate as a regular diet; nor
can any thing contribute more to occafion fevers of the worfl kind
than its oppofite.
   SYMPTOMS.----Low fpirits, want of  appetite,  weaknefs,
wearinefs after motion, watchfylnefs, deep fighing, and dejeaion
of mind, are generally the  forerunners of this difeafe.  Thefe are
fucceeded by.  a quick low pulfe, a dry tongue without any con-
siderable thirft, chillnefs and flufhing  in turns, Sec.
   After fome time^jhe patient complains of a giddinefs and pain
of the head, has a naufea, with reachings and vomiting ; the pulfe
is  quick, and fometimes intermitting; the urine pale; refembling 
r-3-3          OF THE NERVOUS  FEVER.

dead fmall  beer, and the breathing is difficult, with cppreffioii of
the breaft, and flight alienations of mind.
   If towards the ninth, tenth, or twelfth day, the tongue becomes  .
more moift with a plentiful fpitting, a gentle purlin?,, or a moiilurc
uponthe ikin ; or if a fuppuration happens in one or both ears, or,
large puftules break out about the lips and nofe, there is reafon to   (
hope for a favourable crifis.
   But if there is an exceffive loofeiu.Ror wafting fweats, with fre-
quent fainting fits ;  if the tongue, when put ou., trembles exuef-
fively, and the extremities feel cold, with a daturai^ or flow creep-
ing pulfe ;  if there is a flatting  of  the tendons and almoil total
lo(g  of fight  and hearing, and  an involuntary difeharge by flool
^nd urine,  there is great  reafon to fear that death is approaching.
   REGIME v.----It is very neceffary in this difeafe to keep the
patient coof and quiet. The leaft motion will fatigue him, and will
be apt to occafion wearinefs and even  faintings. His mind ought
not only to be kept eafv, but foothed and comforted with hopes of
a fpeedy recovery. Nothing  is more hurtful  in low fevers of this-
kind than prefenting to the patient's imagination gloomy, or fright-
ful ideas. Thefe of themfelves  often occafion nervous fevers, and
muft likewife aggravate them.                      .
   The patient muft not be kept too low. His  ftrength and fpirits
ought to be  fupported by nourifliing diet and  generous cordials.
For this pu< pofe, his gruel, panado, or whatever Sood he takjs, mull
be mixed with wine, according as the fymptoms  may  require.  ^
Pretty ftrong wine-whey, or fmall negus, Sharpened uith thejuice
of orange or lemon, will be proper for his ordinary drink.  Muftard-  ,
whey is likewife a very proper drink, in. this fever, and may be ren-
dered an excellent cordial-medicine by the addition of a propes
quantity of white-wine*-
   Wine, in this difeafe, if it could be obtained genuine, is almoft
the only medicine that would be neceffar/y.   Good wine polfefles
all the virtues of the cordial medicines, while it is free from ma-
ny of their bad qualities.  I fay good  w ine  ;  for, however com-
mon this article of luxury is now become, it  i6 rarely to be  ob».
tained genuine, efpecially by the poor, who are obliged to pur-
chafe it iif fmall quantities*                    *
   I have often feen patients in low nervous fevers, where the pulfe
could hardly be felt, with a conflant delirium, coldnefs of the ex-
tremities,  and almoft every other  mortal Symptom, recover, by
ufing in whey, gruel and negus, a bottle or two of ftrong wine
"every day.  Good old  found claret is the beft,  and may be mada '
into negus,  or given by itfelf,  as circumftances require.
   In a word, the great aim in this difeafe is  to fupport the pa-
tient's ftrength, by giving him  frequently fmall quantities of the
above, or other drinks of  a warm and  cordi^nature.  He is not,,

                  See Appendix, Muftard-whey. 
OF  THE NERVOUS  FEVER.
*39
V.ewever, to be over-heated either with liquor or clothes; arid his
food ought to be light, and given in fmall quantities.
  MEE)ICINE.-J— Where a naufea,  load,  and ficknefs at  fto-
mach  prei ui at. tht. beginning of the /ever, it will be neceffary
to give the patient a gentle vomit.  Fifteen or twenty  grains of
ipecacuanha in fine powder  or a few fnoonfuls of the vomiting
julep-;-, will generally.anfwer this purpose very well.   This may
be repeated any time before the third or  fourth day, if the  above
Symptoms continue. Vomits not only clean the ftomaeh, hut, bv
the general fhock which they g'.ve, promote die perfpiration,  and
have many other ex, client effecrs in'flow fevers,  where there are
no figns of inflammation, ur i nature war :j roufii;;;.
  Such as dare not venture upon a vomit,  may clean the bowels
by an infufion of fenna and manna.                 ,
  In all  fevers, the great peint is to  regulate  the fymptoms, fo as
tn prevent them from going to either extreme.    I hus, in  fevers
of the inflammatory kind, where the force of the circulation is too
great,  or the blood denfe, and the fibres-too rigid, bleeding and
other evacuations are neceffary.   But in nervous  fevers, where
nature flags, and  the  folids relaxed,  wine, with, other cordials
fliould be plentifully adminiftered.
  It is neceffary to caution people againft bleeding in this difeafe,
as there  is generally at the beginning  an univerfal  fLr<£ture upon
the veffels, and fometimes an eppreflion and difficult/ of breath-
ing, which fuggeft the idea of a plethora,  or too great a quantity '
of blood.  I  have kno-vn even fome of  the faculty deceived  by.
their -own feelings in  this refpea, fo  far as to infift upon  being
bled, when it was evident, from the confequences, that the opera-
tion was improper,
  Though bleeding is generally improper in this difeafe, yet blif-
tering  is highly neceffary.   Blifters may be applied at all times of
the fever with great advantage.   If the  patient is delirious, he
ought to be bliftered on the neck or head, and it will  be the  fa-
feft courfe, while the infenfibility continues, as Soon  as the dif-,
charge occafioned by one blifter abates,  to apply another to fome
other part of the  body,  and by that means, keep up  a continual
fucceffion of them till he be out of danger.
  I have been more fenfible of the advantage of bliftering in this
than in any other difeafe.  Blifters not  only ftimulate the folids
to aaion, but likewife occafion a continual difeharge, which may,
in fome meafure,  fupply the want of  critical evacuations,  which
feldom happen in this kind of  fever.  They are moft proper, ei-
ther towards the beginning, or after fome degree of ftupor lias come
on ; in which laft cafe, it will always be proper to blifter the head.
  If the patient is coftive  through the courfe of the  difeafe, it
will be neceffary to iprocure a flool, by giving him every other day
t See  Appendix, Vouiiti;i£ Julep. 
140-         OF THE  NERVOUS FEVER.
 a clyfter of milk and water, with a little Sugar, to which  may be
 added a Spoonful of common fait,  if the above does  not operate.
   Should a violent loofenefs come  on, it may be checked by fmall
 ^uantitieb of Venice treacle  or laudanum, giving  'he patient for
 his ordinary drink the white  decoaion*.
   A miliary eruption fometimes breaks out about the ninth or tenth
 day.  As eruptions are often  critical, great  care  flufld be  taken
 not to retard  Nature's operation in this particular. The eruption
 ought neither to be checked by bleeding ror other evacuations, nor
 pufhed out by a hot regimen ; but the patient ihould be  fuppor-
 ted by gentle cordials, as wine-whey, fmall negus, fago-gruel, with
 a little  wine in it, and fuch-fike.   He  ought not to be kept too
 warm; yet a kindly breathing fweat fhould by no means be checked.
   Though blifters, and the ufe of  cordial  liquors are the  chief
 things to be  depended on in this kind  of  fever; yet, for thofe
 who may choofe to  ufe them,  we Shall mention one  or two of
 the forms of medicine which are commonly  preferibed in itf.
   In defperate cafes, where the hickough and Starting of the ten-
 dons have already come on, we have fometimes.feen extraordinary
 effeas from large dofes of mufk frequently repeated.  Mafic  is
 doubtfefs an antifpafmodic, and may be given to the  quantity of a
 fcruple three or four times a-day, or oftener if neceffary.  Some-
 times it  may be proper to  add to the mufk a few grains of cam-
 phire, and  Salt of harifhorn, as thefe tend to promote perfpiration
 and the difeharge of urine.  Thus, fifteen grains of mulk, with three
 grains of camphire, and fix  grains of fait of hartfhorn, may be made
 into a bolus with a little fyrup,  and given as above.
   If the fever fhould happen  to intermit, which it frequently does
 towards  the decline, or if  the patient's ftrength fhould be wafted
 with  colliquative fweats, &c. it wili be neceffary  to give him the
 Peruvian bark.  Half a drachm, or a whole drachm „ if the ftomach
 will bear it, of the bark in  fine powder, may be given four or five
 times a-day in a  glafs of red port or claret. Should, the  bark in fub-
itance not fit eafy on  the ftomach, an ounce  of it in poivder may be
infufed in a bottle of Lifbon or Rhenifh wine for two or three days, .
 afterwards it may be {trained, and a glafs of it taken frequently!.

  * See Appendix, White Decoaion.
  t When the patient is low, ten grains of Virginian fnake root, and
the fame quantity of contrayerva-root, with five grains of k ufliin. caff or,
 all in fine powder, imy be made into a bolus with alittle of the cordial
 eonfedion or fyrup,of faffron.  One of thefe may be  taken every four
or five hours.                                             J
  The following powder may be ufed  with the fame  intention •  Take
Wild Valerian-root in powder ■one  fcruple, faffron and cLitor each four
grains. Mix thefe by rubbing them together in a mortar,  and give one
in a cup of wine-whey three or four times a-day.
,J J**" bf^m-ay ,!.kc^!re b?'very ProPerly adminiftered, along with
other cordials,  in the following manner :  Of  bark an ounce, o?anie-
peel half an ounc*, Virginian  fnake-root  two dra  I11113  faffron oae 
PUTRID  OR  SPOTTED FEVER.
141
  Some give the bark in this and other fevers, where there are no
fymptoms of inflammation, without afly  regard to the remiflion
or intermiflion of the fever. How far future obfervation may tend
to eftablifh this practice, we will not pretend to Say; but we have
reaSon to believe that the bavk is a very univerSal Sebrifuge, and that
it may be adminiftered with advantage in moft fevers where bleed-
ing is  not neceffary, or where there are no fymptoms of topical
inflammation.
                CHAPTER  XX.

        Of the  Malignant Putrid  cr Spotted Fever.

     THIS may be  called the peftilential  fever of Europe, as, in
      many of its  fymptoms, it bears a great refemblance to the
plague.  Perfons  of a lax habit, a melancholy difpofition, and thofe
whofe vigour has been wafted by long fafting, watching, hard la-
bour, exceffive venery, frequent falivations, &c. are moft liable to it.
   CAUSES.----This fever  is  occafioned by foul  air, from  a
number of people being confined in a narrow place, not  properly
ventilated ; from putrid animal and vegetable effluvia, Sec. Hence
it prevails in camps, jails,  hofpitals,  and infirmaries, efpecially
where  fuch places are too much crowded, and cleanlinefs is ne-
gleded.   *
   A clofe conftitution of the air,  with long rainy or  foggy wea-
ther, likewife occafions thefe fevers.  They often fucceed great in-
undations in  low and marfhy countries, efpecially when thefe1 are
preceded or followed by a hot and Jultry feafon.
   Living too much upon animal Sood,  without a proper mixture
of vegetables, or eating fifh or flefh that has been kept too long, are
apt to occafion this kind oS Sever. Sailors on long voyage?,'and the
inhabitants oS befieged cities,  are very  often vifited \%h this dif-
eafe.
   Corn that has been greatly damaged by rainy feafens cr long
keeping,  and water which has become putrid by ftagnation, Sec.
may likewife occafion this fever.
   Dead carcafes tainting the air, efpecially in hot feafons, are very
r.pt to occafion thefe difeafes. Hence, this kind of fever often pre-
vails in  countries which are the Scenes of war and bloodfhed. This
Shows the propriety of removing burying-grounds, (laughter-houfes,
Sec. to a proper  diftance from great towns.
   Want of cleanlinefs is a very general caufe of thefe fevers.  H_*nce

drachm.  Let all  of them be powdered, and infufed in an'En-'i.'h pint
of the beft brandy for three or four da. •. Afterwards the lijuor imy
be ftrained, and two tea-fpoonfuls of it giv?n three or four times a day
bi a glafs of fuiail wine or negus. 
142
PUTRID OR  SPOTTED FEVER.
they prevail amongft the  poor inhabitants of large towns, who
breathe z confined, unwholefome air,and neglect cleanlinefs. Such
mechanics as carry on dirty employments, and are conftantly con-
fined within doors, are very liable to this difeafe.
   We fhall only add, that  malignant, or Spotted fevers, are highly
infectious,  and  often communicated by contagion. All perfons
ought  to keep at a diftance from thofe  affected with fuch diSeaSes,
unleSs their attendance is absolutely neceffary.
   SYMPTOMS.----The malignant fever is generally preceded by
a -remarkable weakneSs or loSs oS ftrength, without any apparent *
caufe.  This is Sometimes So great, that the patient can Scarce walk,
or even fit upright,  without being in  danger oS Sainting  away.
His mind too is greatly dejected; he Sighs, and is Sull of dreadful.
apprehenfions.
   There is a naufea, and fometimes a vomiting of bile ; a violent
pain of the head, with  a ftrong pulfation or throbbing of the tem-
poral arteries ;  the eyes often appear red and inflamed, with a pain
at the bottom of the orbit; there is a noife in the ears, the breath-
ing is laborious, and often  interrupted with a jigh; the patient
complains of a pain about the region of the  ftomach,  and  in his
back and loins;  his tongue  is at firft white, but afterwards it ap-
pears black and chaped ;  and his teeth are covered with a black
cruft.  He fometimes pafles worms both upwards  and downwards,
is affected with  tremors or fhaking, and often becomes delirious*
   If blood is let, it appears diflolved, or with a very fmall degree
of cohefion, and foon becomes putrid :  the flools fmell*extremely
foetid, and  are  fometimes of a greenifh, black,  or reddifh caft.
Spots  of a pale purple, dun, or black  colour, often appear upon
the fkin, and fometimes there  are violent haemorrhages, or  dis-
charges of blood from the mouth, eyes,  nofe, &c.
   Thefe fevers may  be diflinguifhed from the inflammatory, by
the fmallnefsof  the pulfe, the great dejection of mind, the diflol-
ved ftate of the  blood, the petechia, or purple fpots, and the putrid
fmell of th^excrements.  They may likewife be diflinguifhed frorn
the low or nervous fever by the heat and thirft being greater, the
vrinc of a  higher colour,  and the lofs of ftrength, dejection of
mind,  and all the other fymptoms, more violent.
   Sometimes the inflammatory, nervous, and putrid fymptoms are
fo blended  together, as to render it very difficult to determine to
which clafs the fever belongs. In this cafe, the greateft caution and
Skill are requifite. Attention muft be paid to thofe fymptoms which
are moft prevalent, and both the regimen artd medicines adapted
to them.                          /
  Inflammatory and nervous fevers may be converted into malig-
nant an<' putrid, by too hot a regimen or improper medicines.
  The duration of putrid fevers is extremely uncertain •, fometimes
they terminate  between the feventh  and fourteenth  day, and at
other times they are prolonged for five or fix weeks. Their dura- 
          PUTRID  OR  SPOTTED FEVER.      jj^,

tion depends greatly upon the conftitution of the patient, and the
nivmner of treating the difeafe.
  The moft favourable fymptoms are, a gentle loofenefs after the
fourth or fifth day, with a warm, mild, fweat.  Thefe, when con-
tinued for a conliderable time, often carry  off the fever, and fhould
never be imprudently flopped.  Small miliary  puftules appearing
between the petechue, or purple fpots, are likewife favourable, as
alio hot feabby eruptions about the mouth and nofe. It is a good
Sign when the pulfe rifes upon the ufe of win-?, or other cordials,
and the nervous fymptoms  abate ;  deafnefs coming on towards
the d. cl ne of the fever, is often a favourable fymptom*, as are
abfccihs in the groin  or parotid glands.
   Among the unfavourable fy mptoms,may be reckoned an exceffive
looSenef ^ with a hard fwelled belly ; large black or livid blotches
breakni"- out  upon the fkin ;  aptlise in the mouth; cold clammy
 Sweats ; blindnefs; change of the voice •,  a  wild flaring  of the
 eyes ; difficulty of Swallowing; inability to put out the tongue ;
 and a conftaivt inclination to uncover the breait. When the fweat
 and faliva are tinged with blood, and the urine is black, or depofit.-J
 a blick footy  Sediment, the patient  is in great danger.  Starting df
 the tendons, and Scetid, ichorous, involuntary flools, attended with
 eoldneSs oSthe extremities, are generally  the forerunners of death.
   REGIME.N-----In the  treatment of this difeafe, we ought to
 endeavour as far as poffible, to fupport the patient's ftrength and
 fpirits; and to  affiil  Nature in expelling the  caufe of  the  difeafe*
 by gently promoting perfpiration and the ether evacuations.
   Putrid fevers are  often occafioned by unwholefome air, and of
 courfe they mult be aggravated by it.  Care ihould be taken to pre-
 vent  air from  ftagnatir.g in the  patient's chamber, to keep  it
 cool, and renew it frequently, by opening the doors or window,*
 of feme adjacent apartment.  The  breath and perfpiration of per-
 feu'is  in perfect health  foon render the  air of a fmall aparcmeng
  noxious, but this will fooner  happen  from the perfpiration and
  breath of a perfon in this diieufe.
    Belides the frequent admiifion of frefh air, we  recommend th«3
  ufe of vinegar, verjuice, juice of lemon, Seville orange, or any ve-
  getable acid that can be moft readily obtained.  Thefe ought fre-
  quently to be Sprinkled upon the floor, the bed, and every part of
  the room.  They may alfo be evaporated  with a hot iron, or by boil-
  ing, &c. The frefh ikins of lemons or oranges ought to be laid in
  diflerent parts of the room,  and fiiould be frequently held to the
  patient's nofe.   1 he ufe of acids in this  manner would prove very
  refrefhing to the patient, and tend to prevent the infection from
  fpreading among thofe who attend him. Strong feented herbs, as
  rue, tanfy, rofemarv, wormwood, &c. may be laid m different parts
  of the houfe,  and fmelled to by thofe who go near the patient.

    *   Deafnefs is not always a favourable fymptom in this difeafe. Per-
  haps it is ciiiy fo when ©ctafiontt] by abfeciks formed within the e^r- 
U4       PUTRID OR  SPOTTED  lEVLR.

  The patient muft be kept cool, quiet and eafy..  The leaft  noife
will affect his head, and the fmall ell fatigue will be apt to  make
him faint.
  Few things are of greater importance in this difeafe than acids,
which  ought to be  mixed with all the patient's food, as well as
drink.  Orange,  lemon, or vinegar  whey, are all very proper, and
may be drank by turns, according to  the patient's inclination.  They
may be rendered cordial by the addition of wine in  fuch  quantity
as the patient's ftrength feems to require.  When he is very low,
he may drink negus, with only one half water, and fharpened with
the juice of orange or lemon.  In fome cafes, a glafs of clear  wine
may now and'theri be allowed. The moft proper wine is Rhenifli,
but  if the body be open, red-port or claret is  to be preferred.
  When the body is bound,  a tea-fpoonful of the cream  of  tartar   a
may be put into a cup of the patient's drink,  as there is occafion;
or he may drink a decoction of tamarinds, which will both quench
his thirft, and promote a  difeharge by flool.
  If camomile-tea will fit upon his ftomach, it is  a very propet,  *
drink,  It may be fliarpened by adding to every cup of the tea ten
or fifteen drops of the elixir of vitriol.        •
  The food muft be light, as panado or groat gruel, to which a
little wine may be added,  if the patient be weak and low ; and they
ought all to be fliarpened  with the juice cS orange, the jelly of cur-
rants, or the like. The patient ought likewife to eat i'reely of ripe
fruits,  as roafted apple?, currant  or goofeberry tarts,  preferved
cherries, or plumbs, &e.
  Taking a little  food or clrink fupprvts the fpirits : for which rea-
fon, the patient ought feequfntiy co be Sipping Small quantities of
fome of the acid liquoi s mentioned  *bove, or any that may be moTe
agreeable to his palate or  more readily obtained.
  If he is delirious, his feet and hands ought to be frequently fo-
mented with-a ftrong infufion of camomile  flowers.  This, or an
infufion  of the bark, to fuch as can afford it, cannot fail to have a
good effect. Fomentations of this kind relieve the head,  by  relax-
ing the vefl'els in the extremities.
  MEDICINE.----If a  vomit be. given at the beginning of this
fever, it  will hardly fail to have a good effect; but if the  fever has
gone on  for fome days, and the Symptoms are violent, vomits are
not quite fo fafe.  The body however is.always to  be kept gently
open by  clyfters,  or mild laxative medicjnes.
 . Bleeding is feldom  neceffary in putrid fevers.  If there be figns
of an inflammation, it may fometimes be permitted at the firft on-
Set; but the repethioa of it generally proves hurtful.
  Blifters  are never to be ufed unlefs in the greateft extremities.
If the petechia; or fpots  fliould fuddenly difappear, the  patient's
pulSe  fink remarkably, and a delirium, with  other bad Symptoms,
come on, blistering may be .permitted.  In this Cd(e, blifters are to
be applied to die head, and infide cf the legs or thighs. But as tlvy 
            putrid  or spotted  fever.      145
                                                         ■caco«c<
.are Sometimes apt to occafion a gangrene, we would rather recom-
 mend warm cataplaSms or poultices of muftard and vinegar to be
 applied to 'the feet, having recourfe to blifters only in  the utmoft
 extremities. It is common in the beginning of this fever  to.give the
 emetic tartar in fmall dofes, repeated every fecond or third hour, till
 it fhall either vomit, purge, or throw the patient into a fweat. This
 practice is very proper, if not pufhed fo far as to weakenthe patient.
    A ridiculous notion has long prevailed, of expelling the poifon-
 ous matter of malignant difeafes by  trifling defes' of cordial or
 alexipharmic  medicines. In confequence of this notion,  the con-
 trayerva-root, the cordial  confection, the mithridate, &c. have
 been extolled as infallible remedies.  Thefe feldom  do much good-
 Where cordials are  neceffary, none is fuperior to good wine; and
 we again recommend it  both as the fivfeft and beft.  Wine acids
 and antifeptics are the only things  to be relied on in  the cure of
 malignant fevers.
    In the moft dangerous fpecies of this difeafe, when it is  atten-
 ded with purple, lived, or black fpots, the Peruvian'bark muft be
 adminiftered.  I have Seen it, when joined with acids, prove Success-
 ful, even in cafes where the petechia; had the moft  threatening
 aSpect. Bur,  to anSwer this purpoSe, it muft not only/be given in
 large doSes, but duly perfifled in*.                        *
    The beft method oS adminiftering the bark is certainly in fub-
 ftance.  An' ounce of it in powder may be' mixed with half an
 Englifh pint of water, and the fame  quantity of red wine, and fhar-
 pened with the elixir or the Spirit oS vitriol, which will both make
 it fit eafier on the Stomach, and render it more beneficial.  Two
 or three ounces of the Syrup of  lemon may be added,  and two ta-
 ble-Spoonfuls  of the mixture taken  every two hours, or oftener, if
 the ftomach is able to bear it. Thofe who cannot take  the bark in
• fubftance may infufe it in wine,  as recommended in the preceding
 difeafe. If there be  a violent loofenefs, the bark muft be boiled in
 red wine with a little cinnamon, and fharpened with the elixir of vi-
 triol, as above.  Nothing can be more beneficial  in this kind of
 loofenefs than plenty of acids, and fuch things as promote a gentle
 perfpiration.
    If the patient be troubled v/ith vomiting, a drachm of the falj; of
 wormwood, diffolved in an ounce and an half of frefh lemon-juice,
 and made into a draught with-an ounce of fimple finnamon water,
 and a bit of fugar, may be given, as often as neceffary.
   If Swellings oS the  glands appear,  their Suppuration  is to be
.promoted by the application of emollient poultices. As foon as there
 is any appearance of matter in them,  they ought to be raid open,
 and the poultices continued.                             •

   ■X- In fevers of this type,  accompanied  with great proftration of
 ftrength, Madeira wine fliould be adminiftered with anunfparing hand,
 beginning with fmall quantities, and" gradually increafing from  one to
 two bottles, in the courfe of fsyenty-four hours.    (I. C )
                             T 
146      PUTRID  OR SPOTTED FEVER.

   I have known large ulcerous fores break out in various parts of
the body, in the decline of this  fever, of a livid gangrenous ap-
pearance,  and a moft putrid cadaverous fmell.  Thefe gradually
healed ; and the patient recovered by the plentiful ufe of bark and
wine,fharpened with the fpirits of vitriol.
   For preventing putrid fevers, we would recommend a Strict re-
gard to cleanlinefs; a dry  fituation; Sufficient exerciSe in the open
air ; wholeSome Sood, and a moderate uSe of generous liquors.  In-
fection ought above all  things to be avoided. No conftitution is
proof againft it. I have known perfons feized with a putrid fever,
by only making a fingle vifit to  a patient in it; others have caught it
by lodging for one night in a town where it prevailed ; and fome
by attending the funerals of fuch as died of it*.
   When a putrid fever feizes  any perfon in a  family, the greateft
attention is neceffary to prevent the difeafe from fpreading.  The
fick ought to be placed in a large apartment, as remote from  the
reft of the family as poffible; to be. kept extremely clean, and to have
frefh air frequently let into his  chamber; whatever comes from him
fhould be  immediately removed, his linen frequently changed, and   j
thofe inhealthoughttoavoidallunneceffarycommunicationwithhira.
   Any one who  is apprehenfive of having caught the infection,
ought immediately to take a vomit, and to work it off by drinking
plentifully of camomile tea. This may be repeated in a day or two,
if the apprehenlions ftill continue, or any unfavourable fymptoms   i
appear. He ought likewife to take  an infufion of the bark and   I
camomile flowers  for his ordinary drink ;  and before he goes to
bed, he may drink an Englifh pint of pretty ftrong  negus, or a few
glaffes of  generous wine.  I have frequently followed this courfe,
when  malignant fevers prevailed,, and have recommended it to
others with conflant fuccefs.
   People generally fly to bleeding and purging as antidotes againft
infection ; but thefe are fo far  from fecuring them, that they often,
by debilitating the body, increafe the danger.
   Thofe who wait upon  the fick  in this difeafe ought always to
have a piece of fpunge or a handkerchief dipt in vinegar, or juice
of lemon, to fmell to while near the patient. They ought to wafh
their hands, and, if poffible, to change their clothes, before they go
into company-fv

   ■9f The 1-ate Sir John Pringle exprefled  a concern left thefe cautioss
ihould prevent people from attending their friends or relations when
afflicted with putrid fevers.  I told him I meant only to difcourage  -
iini)ecefTarj( attendance, and mentioned a number of inftances where
putrid fevei-s had proved,fatal to perfons who were rather hurtful than
be»ie*cial to the fick. He agreed with me, that a good doftor and a care-
ful nurfe were the only necelfary attendants;  and.that all others not
only endangered themfelves, but, generally, by their folicitude and ill-
direcled care, hurt the fick.
  t Thefe are prudent precautions, particularly cleanlinefs; as to moil
of the  others,  recommejided by our judicious author, they feemed w> 
C   H7   3
               CHAPTER   XXI.

                   Of the Miliary Fever.

     THIS fever takes its name from the fmall  puftules or bladders
      which  appear on the fkin, rtfembling,  in fhape and Size,
the Seeds oS millet.  The puftules are either red or white, and fre-
quently both are mixed together.
   The whole body is Sometimes  covered with puftules; but they
are generally  more numerous  where the Sweat  is moft abundant,
as on the breaft, the back, &c. A gentle Sweat, or moifture on the
fkin, greatly promotes the eruption ; but, when the fkin is dry, the
eruption is both more  painSul and dangerous.
   Sometimes this is a primary difeafe;  but it is much oftener only
a Symptom oSfome other malady,- as the fmall-pox, meafles, ardent,
putrid, or nervous  fevers, Sec. In all thefe cafes it is generally the
effect of too hot  a regimen or medicines.
   The miliary fever chiefly attacks the idle and the phlegmatic, or
perfons of a relaxed habit. The young and the aged are more liable
to it  than thofe in the vigour and prime of life.  It is likewife more
incident to women than men, efpecially the delicate and indolent,
who keep continually  within  doors, and live  upon weak watery
diet.  Such females are extremely liahle to be feized w ith this difeafe
in childbed, and often loofe their lives by it.
   CAUSES.----The miliary fever is fometimes occafioned by vio-
lent  paffions or affections of the  mind ; as exceffive grief, anxiety,
thoughtfulnefs, &c. It may be occafioned  by exceffive watching,
gTeat evacuations,  a weak watery diet, rainy  feafons, eating too
freely of cold, crude  unripe fruits, as plums, cherries, cucumbers,
melons, Sec.  Impure  waters, or provisions which have been fpolied
by rainy  feafons,  long keepmg, &c.  may caufe miliary  fevers.
They may alfo  be occafioned by the ftoppage of any cuftomary
evacuation, as iflues, fetons, ulcers, the bleeding piles in men, or the
menftrual flux in women, &c.
   This diSeafe in childbed-women is Sometimes the effect of great
coftivenefs during pregnancy ;  it may likewiSe be occafioned by
their exceffive uSe oS green trafh, and other  unwholeSome things,
in which pregnant women are too apt to indulge. But its moft ge-
neral cauSe is indolence. Such women as lead  a Sedentary life, ef-
pecially during  pregnancy, and at the  fame time live grofsly, can
hardly  efcape this difeafe in childbed.  Hence it proves extremely
 fatal to women  of fafhion, and likewife to thofe women in manu-
facturing towns,  who, in order to affift  their hufbands, fit clofe

 have little or no effete, during the late yellow fever, which provailed in
 Philadelphia.  We believe the beft preservative, if it could be attained,
 i.a cneerfuland undifturbed ft^te of mind.    (I. C) 
148         OF  THE  MILIARY FEVER.

within doors for almoft the whole of their time. But among wo.
men who are active^nd laborious, who live in  the country, and
take Sufficient exerciSe without doors, this  diSeaSe  is very little
Jcnown.
   SYMPTOMS.----When this is a primary thfeife, it makes its
attack like moft other eruptive fevers, with a flight Shivering, which
is fucceeded by heat, lofs of ftrength, SaintifhncSs, fighing, a low
quick pulSe, difficulty of breathing, with great anxiety and oppreS-
f-ion of the breaft. The patient is reftlefs, and  fometimes delirious;
the tongue appears white, and the hands (hake,-with often a burn-
ing heat in the palms'; in childbed-women the milk generally goes
away, and other difcharges flop.
   The patient feels anitching or pricking pain under the fkin, after
which innumerable fmall puftules of a  red or white colour begin
tcappear. Upon this the fymptoms generally abate, the pulfe be-
comes more full and Soft, the fkin grows moiftcr,  and the Sweat, as
the diSeaSe advances,  begins to have a peculiar Szetid  Smell; the
great load on the breaft, and oppreffion  of the Spirits, generally go
off, and the cuftomary evacuations gradually return.  About the-  v!
Sixth or Seventh day from the eruption,  the puftules begin  to dry
and fall off, which occafions a very difagreeable itching in the fkin.
   It is impoflible  to afcertain  the  exact time when  the  puftules
will either appear or go off. They generally come out on the third
or fourth day,  when  the eruption is critical ; but when fympto*
matical, they may appear at any time of the difeafe.
   Sometimes the puftules appear and vanifh by turns. When that    '
is the cafe, there is always danger ; but when they go in  all of a
fudden, and do not appear again, the danger  is very great.
   In childbed-women the puftules are commonly at firft filled with
clear water,  afterwards they grow yellowifli.   Sometimes they are
interfperfed with puftules of a red colour. When thefe only appear
the difeafe goes by the name of a rnflj.
   REGIMEN----In all  eruptive fevers, of whatever kind, the
chief point is to prevent the fudden difappearing of the puftules,
and to promote their maturation. For this purpofe the patient muft;
be kept in fuch a temperature, as neither to pufli out the eruption
too faft, nor to caufe it to retreat prematurely. The diet and drink   \
ought therefore to be in a moderate degree nourifliing and cordial;
but neither ftrong nor heating. The patient's chamber ought nei-
ther to be kept  too hot nor cold ; and he  fliould not be too much
covered v/ith clothes.  Above all, the mind is to be kept eafy and
cheerful. Nothing fo certainly makes an eruption go in as fear, or
the apprehenfion of danger.
  The food  muft be weak chicken-br.oth with bread, panado, fago,
or groat-gruel, &c. to a gill of which may be added a fpoonful or
two of wine, as the patient's ftrength requires, with a few grains   ,
of fait and a little fugar.  Good apples roafted or boiled, with oth«f
ripe fruits of an opening cooling nature, may be  ea;en. 
               OF  THE  MILIARY FEVER.           149

•   The drink may be Suited to the State oS the patient's ftrength
 and Spirits. If thefe be pretty hfeh, the drink-ought to be weak ; as
-water-gruel, balm-tea, or the decoction mentioned below*.
   When  the  patient's fpirits are low, and the eruption coes> not
 riSe Sufficiently, his drink muft be a little more generous ; as wine-
 whey, or Small negus,  fliarpened with the fu«ice oS orange or lemon,
 and made Stronger Or weaker as circumftances may require.''.
   Sometimes  the miliary SeVer approaches towards a putrid nature,
 in which caSe the patient's ftrength muft be Supported  with gene-
 rous cordials, joined with  acids;  and, iS the degreeoSputreScence
 be great, the bark muft be given.  If the head be much affected, the
 body muft be  kept open by emollient clyiter;--!-.               v
   MEDICINE.----If the food and  drink bj properly regulated,
 there will be little occafion for medicine in this difeafe.  Should the
 eruption, however, not rife, or the Spirits Hag, it will be neceffary to
 Support the  patient with cordials, and to apply blifters.  The  moft
 proper cordial, in this  caSe, is good wine, which may either be ta-
 ken in  the patient's food or drink ; and if there be flgns of putre-
 fcence, the bark and acids may be mixed with wine, as directed in
 the putrid fever.
   Some recommend blistering through the whole courfe of this
 difeafe; and where Nature flags, and the eruption comes, and goes,  >
 it  may be necefiary to keep up a ftimulus, by a Continual fucceffion
 of fmall blifters, but not above one at a time. If the pulfe finks re-
 markably, the puftules fall in, arid the  head is affected, it will be
 neceffary to apply Several  blifters to the iv.cl Senfible parts, as the
 infide of the legs and-thighs, &c.

   •# Take two ounces of the mavinf- /-; of harLfhorn, and the fame quan-
 tity of farfiparilla,  boil them in two En-.y.ih  quarto cf water.  To the
 ftrained decoction add a. little white fugar, and let the paLitnt take it for
 his ordinary drink.                                                i
   |  In the  Cornniercium Ljterarium for the year r -35, we have the hif-
 tory of an epidemical miliary fever, whkh raged at Strafburgh in the
✓mouths of November, December, and January-;  from whici: we  learn
 the neceffity of a temperaie regimen in this malady, and likewife that
 phyficians are not always the firit who clifcover the proper treatment of ,
 difeafes. " This fever made terrible kavock everf among men of robuft
 canfritutioii'3, and all medicine proved in vain.  They were feized in -an
 inftant with.miveriiig, yawning, Urctching and  p;v.;s in che back, fuc-
 ceeded by a moil intenfe heat;  at the fai:.e time there was  a great lofs
 of ftrength and appetite. On the feventh or ninth day the miliary erup-
 tions appeared, or fpots like i'.-e-bite;,, wi:h r,.-<?at anxiety,  a delirium,
refUeffiiefs, and toffing in bed. Biecdirg w:is fatal.  While matters were,
in thisunhappv fituation, a midwife, of her own accord, gave to a patient,
in the height of the difeafe, a clyfter of rain-water and.butter without
 fait, and for his ordinary drink a quart of fpring water, half a pint of
generous wine, the juice of a lemon, aad fix  ounces  of the whiteft fu-
gar, gently boiled till a fcum arofe, and this with great fucsefs ; "for the
 belly'wasfoon loofened, the grievous fymptoms vaniflied, and the patient
was reftored to his fenfes, and fuatched from the jaws cf de-th."  This
practice was imitated by others with the like happy effect*. 
150
OF  THE  REMITTING FEVER.    •
  Bleeding is feldom neceffary in this difeafe,  and fometimes it
does much hurt, as it weakens the patient, and depreffes his fpirits.
It is never to  be attempted unlefs by the advice of a phyfician.  It
has been cuftomary to  treat this difeafe in childbed-women by
plentiful bleeding, and other evacuations, as if it were highly in-
flammatory. But this practice is generally very unfafe.  Patients in
this fituation bear  evacuations very ill.   And indeed the difeafe
feems often to be more of a putrid than of an inflammatory nature.
  Though this fever is  often occafioned in  childbed-women by
too hot a regimen, yet  it would be dangerous to leave that off all
of a fudden,  and have recourfe to a very cool regimen,  and large
evacuations. Supporting the patient's fpirits, and promoting natural
evacuations, is here much Safer  than  having recourfe to artificial
ones; as theSe by finking the Spirits, Seldom Sail to increafe the danger.
  If the difeafe proves  tedious, or the  recovery flow, the bark may
be taken in fubftance,  or infufed in wine or water, as  the patient
inclines.
  The miliary fever, like other eruptive difeafes, requires gentle
purging, which  fhould not be neglected as foon as the  fever is
gone cT, and the patient's ftrength will permit.
  To  prevent this difeafe, a pure  dry air, fufficient exercife, and
wholefome food,  are neceffary.  Pregnant women fhould guard
againft coftivenefs, and  take daily as much exercife as they can bear,
avoiding all green trafhy Sruits, and other unwholeSome things; and
when  in childbed, they ought SlrittJy to obServe a cool regimen.
               CHAPTER    XXIL

                  Of the Remitting Fever.

    THIS fever takes its name from a remiffion of the fymptoms,
     which happens fometimes fooner, and  fometimes later, but
generally before the eighth day.  The remiffion is commonly pre-
ceded by a gentle Sweat, aSter which the patient Seems greatly re-
lieved, but in a few hours the fever returns. Thefe remiffions return
at very irregular periods,  and are fometimes  of  longer, Sometimes
of Shorter dun.don ; the nearer however that the fever approaches
to a regular intermittent, the danger is il 3 lefs.
  CAUSES.-----Remitting fevero prevail in low marfhy countries
abounding with wood and ftagnating water; but they prove moft
fatal in places where great heat and moifture are combined, as in
fome parts of  Africa,  Bengal ;n the E.ift Indies, &c. where remit-
ting fevers are generally of «> putrid kind,  and prove very fatal.
They are moft frequent in dole calm weather, 1 Specially after rainy
<eafons, great inundation?, or the like. No age, fex, or conftitution, 
OF  THE  REMITTING FEVER.
151
is exempted from the attack of this fever,; but it chiefly Seizes per-
fons of a rel.ixed habit, who live in low dirty habitations, breathe an
impure ftagnating air, take little exercife, and ufe unwholefome diet.
.  SYMPTOMS_____The firft fymptoms of this fever are generally
yawning, flretching, pain, and giddinef3 in the head, with alternate
fits of heat and cold.  Sometimes the patient is affected with a
delirium at the very firft attack.  There is a pain, and fometimes a
Swelling, about the region of the ftomach, the tongue is white, the eyes
and fkin frequently appear yellow, and the patient is often afflicted
with bilious vomitings.  The pulfe is fometimes  a little hard,  but
feldom full, and the blood, when let, rarely fhows any  figns of in-
flammation. Some patients are exceedingly coftive, and others are
afflicted with a very troublefome loofenefs.
   It  is impoflible to defcribe all. the fymptoms of this difeafe, as
they vary according to  the fituation, the feafon  of the  year, and
the conftitution of the patient.  They may be greatly  changed by
the method of treatment, and  by many other circumftances. Some-
times the bilious  fymptoms predominate, fometimes the nervous,
and at other times the putrid. Nor  is  it uncommon to find a fuc-
eeffion of each of thefe, or even a complication of them at  the
fame time, in the fame perfon.
   REGIMEN.----The regimen muft be adapted to the prevailing
fymptoms.  When there are any figns  of inflammation, the diet
muft be  flender, and the drink weak and diluting.  But when ner-
vous or putrid fymptoms occur,  it will be neceffary to  fupport the
patient with food and liquors'of a  more generous  nature, fuch as
are recommended in the immediately preceding fevers. We muft
be very cautious in ufing things of  a heating quality, as  this fever
is frequently changed into a continual by an hot regimen, and im-
proper medicines.
   Whatever the fymptoms are, the  patient ought to be kept cool,
quiet, and clean. His apartment, if poffible, fhould be large, and
frequently ventilated by letting in frefh air at the doors or winders*
It ought  to be fprinkled with  vinegar, juice of lemon,  or the like.
His linen, bed-clothes, &c. fhould  be frequently changed, and all
his excrements immediately removed.  Thefe precautions are of
more importance to the fick than  practitioners are apt to imagine*.
  MEDICINK-----In order to cure this fever, we muft endeavour
to bring it  to a regular intermhlion.  This intention may be pro-


  ■5f*Dr. Lind, of Edinburgh, in his inaugural dUTertation concerning the
putrid remitting fever of Bengal, has the following obfervation :  4V The
patient's lhin , bed-clothes, and bedding, ought frequently to be chan-
ged  and expofed to the air, and all hh: excrements im,': -diately remo-
ved ; the  bed-chamber fhould be well ventilated, and frec;»ently  fprin-
kled with vinepv.r , ^ninor^., every attention mould be paid to ihe patient.
I  can af.irm, that a phyfician. who puts thefe in* pr;: tice will much oftener
fucceed than one who. U even more fkilful, I >- has not opportunity of
ufing thefe means." ' 
i^2         OF  THE YELLOW  FEVER.
r  ned by bleeding*, if there be  any figns of inflammation ; but
when that is not the cafe, bleeding ought  by no means to beat-
tombed, as it will weaken the  pa<:l^t and prolong the difeafe. A
vomit however will feldom be improper, and is generally of great
fervice. Twenty or thirty grains of ipecacuanha will anfwer this
purpofe very well; but, where it can be obtained, we rabher recom-
mend a grain or two cf tartar emetic, with  five or fix grains of ipe-
cacuanha, to be made into a draught and given for a  vomit. This
may be repeated once or twice at proper intervals,  if the fickoefj
or nauSea continues.
   The body ought to be kept open either by clyfcers or gentle lax*
atives, as weak inSufions of fenna and manna, fmall  dofe; of the
lenitive electuary,  cream of tartar,  tamarinds, ftewed prune*; or
the like; but all ftrong or draftic purgatives are  to  be carefully
avoided.
   By this courfe, the fever, in a few days, may generally be brought
to a pretty regular or diftinct intermiffion,  in which cafe the bark
may be adminiftered, and it will feldom fail to perfect the cure. It
-is needlefs here to repeat over again the methods of giving the bark.
   The moft likely way to avoid  this fever is to ufe a wholeforhe
and nourifhing diet, to pay the moft Scrupulous attention to clean-
linefs, t° keep the body warm, to take Sufficient exercife, and in hot
 countries, to avoid damp Situations,  night air, evening dews,and
the like.  In countries where it is e'ndemical, the Left preventive
medicine which we can recommend, is the Peruvian  bark, whieh
may either be chewed, or inSuSed in  brandy or wine, &c. Some,*
recommend Smoking tobacco as very beneficial in marfhy counttoJLii
both for the prevention of this and intermitting fevers.       - *"
               CHAPTER   XXIII.

                   Of the Yellow Fever.

     HIS fever dlifers materially from every other Species oS fever
      that has appeared in North- America. A minute defeription,
therefore of its fymptoms, and the moft effectual method of cure,
may be  an acceptable  chapter to this work.  No particular varia*
tion from what appeared in Philadelphia in the fummer and au-
tumn of 1793,  has fince been difcovered  in its  ravages in other
popular cities on the continent  of America  ; we therefore fhall
only detail the former, as being  more generally deftructive,  and
more within the teach of our immediate obfervations.       »
   This  yellow feyer  derives  its appellation, from  the  yellow

    Blifters fliould be applied to the arms or legs at an early period «f
this dTfeafe, as thev have an evidentgood eaecbin procurice ail iiiterniif-
lion of the fever.     [I. C]  <•                     " 
              OF THE  YELLOW  FEVER.         155

 fufFufion,  that  often appeared in the eyes  and on the fkin dur-
 ing the continuance of the difeafe. As it was not a general appear-
 ance, there may be an impropriety in the term.  However, as it
 has been adopted, we will not contend for a word with thofe me-
 dical gentlemen  who agree with us in ideas.
   Various caufes have been fuggefled  for this  difeafe; fome
 have fuppofed it to  be indigenous, and the offspring of Vegetable
 putrefaction ;  others, that it was imported from the Weft-Indies,
 and highly contagious in its nature.   The latter of thefe opinions,
 is fupported by  more facts,  and  appears the raoft probable.   In
 its previous visitations in this country, which were in fix  differ-
 ent periods, befides  that of 1793, it  was always  traced  to have
 been imported  from the Weft-Indies.  It vifited  Charleston, in
 South-Carolina, four times, accofding to the accurate Dr. Lining,
 viz. in 1732, 1739,  1745, and in  1748. It appears, alfo, from Dr.
 Lind*, that it was introduced in  1740, by a trunk of wearing ap-
 parel ; and from the notes of Dr. Redman,  it feems to have been
 brought to this city in 1762, by a mariner, who arrived fick.  From
 that period, it was not obferved  in Philadelphia,  till the  afore-
 mentioned memorable year 1793.  The 3d of Auguft was  the firft
 day it was difcovered ; which was in Water-Street, between Mul-
 berry and SaffaSras-ftreets, at a boarding-houSe,  generally frequen-
 ted by feamen. Many of thefe people belonged to the zebec pri-
 vateer Sans Culottes of Nantz, which had juft  entered the  Dela-
 ware from a cruize, with the Ship Flora, her prize.  The voyage of
 thefe veflels, from every circumftance that could be collected, ap-
 pears to  have brought the difeafe indirectly from the Weft-Indies
 into this city, by exchanging part of her crew for that of the  prize,
 who, were from  the Weft-India  iflands,  where this difeafe was
 raging with violence.
   The people moft generally  affected, were the  native inhabitants
 of  Philadelphia,  or  of fome  or  other parts of the continent  of*
 Americaf. No condition or fituation in life was  exempted from  its
 violence.  The timid of both  fexes, the moft healthy,  and thofe
 who feemed to have  all the vigour of youth on their fide, fell vic-
 tims to it: No age Scarcely efeaped, from the child in the cradU
 up to confirmed manhood, and even from that to extreme old age.
 Women  during geftation appeared to be generally fufceptible of  it-
 In thefe, it often  produced abortion or mifearriage.  It was, how-
 ever, more fatal to the male than the  female fex ;  but, the moft
 cheerful, fearlefs  and gay, of both fexes, often efcaped it,  as like-
 wife idcots,  and thofe who had been deranged  in their minds.


  ■*  Lind on infe&ion, page 293.
  t Strangers from the Weft-India Iflands were feldom attacked with
 this difeafe, and the negroes originally from  the coaft  of Africa, were
fcarcely ever affected, but fome of thofe of our own  country feli a facrU
See to its violence.   (I. C)
                             V 
x54
OF  THE  YELLOW  FEVER.
   SYMPTOMS.----This difeafe moft frequently attacked people
 in the courfe of the night, or early in the morning, with feme degree
 of general laflitude, lofs of appetite, difagreeable tafte in the mouth,
 fudden proftration of ftrength,accompanied withuniverfal pain and
 forenefs over the body, particularly about the large joints.  Thefe
 were foon after fucceeded  by fome degree of chilneSs, or alternate
 chills and fluflies of heat, but very feldom a complete rigor.  Du-
 ring the continuance  of this ftate, the face appeared pallid, the fea-
 tures contracted, the whole countenance exhibiting .a dejected af-
 pect, with  a correfponding ftate of mind.  After this, there was
 perceived a flight pain in the fore or back part of the head, and frer
 quently fome degree  of vertigo, with a fenfe of  fatigue commonly
 about the loins, often extending towards the iliae and pubesji to-,
 gether  with an uneafy fenfation between the Shoulders and back of
 the  neck. TheSe Symptoms hourly increaSed in  violence, attended
 frequently with difagreeable eructations, nauSea,  and Srequent
 retching to vomit, particularly aSter taking large draughts of warm
 or cool drinks, or upon motion of the body.
   The eyes were generally highly fu flu fed, exhibiting the appear-
 fince of a painted eye or one minutely injected,  accompanied with
 n fenfation as if irritated by fand, and generally an aver lion to light.
 This I  have often obferved to take place during the rigor, although
 generally at a more advanced period  of the difeafe, or  fometimes
 not at  all during the whole couide of it.
   After  the rigor, the pulfe generally became frequent, tenfe,'and
 'tolerably even; at other times foft and irregular, the heat moftlya
 little higher than the healthy flandard. The ftate of the  fkin varia.
 hie,"fometimes moift, but  generally dry ;  refpiration a little more
 frequent than ordinary, attended with fighing  and oppreflion at
 the  prsecordia,  indicating  great  diftrefs.  Thefe were  obfervable
 even from the acceffion of the rigor ;  at other times  not until a
 more advanced period.
   The  tongue was  generally  moift  and white,  efpecially in the
 middle,  and red or of a purplifh hue towards the edges and tip;,
 The bowels were generally coftive, but Sometimes had a diarrhoea,
 urine of.a higher colour than natural, and fmall in quantity.
   As the evening approached, every fymptom became aggrav^ted^ ' -1
 the  pulfe more frequent, full and ftrong, heat confiderably aug-  !
 mented,  pain in the head and  back excruciating ;  in the formcty
 {hooting from temple to temple, in the latter jo the hips, and«c-<
 tending down the thighs; fkin dry and parched, fometimes a paftial
 moifture, particularly when the bed-clothes were increafed, but
 without  any abatement of the febrile fymptoms.
   The ficknefs and  retching increaSed, with an ejection of frothy
 pr bilious matter, or whatever fluid was laft received into the ftor
 mach,  accompanied with  pain  and forenefs in  the region of the
v jftomach, upon the leaft preffure, with a fenfation of inceffant burn-
 ing, and reftleffnefs; fo that no pofture afforded any relief. During 
              OF THE YELLOW FEVER-          155

 the exacerbation,  the  refpiration became more frequent, with an
 increafe of fighing, and flight pain and throbbing in one or other
 of the hypochondriac regions, with ftrong bearing in the moft con-
 fpicuous arterial trunks. The face was very much flufhed, and the
 features considerably distorted, with a flight haemorrhage from one
 or both noftrils, and an increafed fuffufion of the eyes.
   The intellectual faculties at times appeared eonfufed, but feldom
 in a complete delirium.  In the intervals of reafon, the paiient was
 very defponding, and under dreadful apprehenfions for the events
 He complained much of thirft,.which was almoft infijtiable, for no
 fooner did any fluid reach the ftomach, than it was inftantly reject-
 ed with violence.  Every  morning. the- fymptoms  fuffered  fome
 abatement-, and the patient generally during the firft twenty-four
 or forty-eight hours  complained of light fhivering, which became
 varied  throughout, the day,  with  viciffitudes of heat and partial
 moifture on the fkin.  He feemed much  inclined to doze, from
 which he was very often awaked by frightful dreams; after which
 he generally became very watchful.  As the difeafe proceeded, the
 tongue was very little altered from a ltate of health, except appear-
 ing in furrows, or chopped and of a bluilh colour ; r.t other  times;
 yellow  or brown in the middle, and  bluifli at the  edges and tip,
 but feldom dry.  Stools, when procured, were generally feetid and
 frothy, but feldom bilious. The urine was  variable, generally of a
 higher colour than natural.  Some of thefe  fympioms which mark-
 ed the firft ftage, proceeded  rapidly to increafe, with a mitigation
 of others, and the rife of new ones, unlefs an  intermiffion fuper-
 vened on or before the fourth day, and the  patient recovered. But
 moft frequently, inftead of this  intermiffion, a mere compofure of:
 fymptoms only took place, which was too often fallacious. During
 this, the eyes and fkin fometimes became yellow, and the patient
 appeared fo placid to the attendants,  that they oSten thought him
 out oS danger. But this treacherous tranquillity Soon vanifhed, and
 the Second ftage  commenced with a different train  of fymptoms,
 and  with redoubled  violence.  The vigour which before was ex-
 ceffive, now declined apace, and the diSeaSe put on a different com-
 plexion. The pain  in the head and back, which was before excef-
 five, and almoft  intolerable,  frequently abated on a fudden, and
 the Sever aflumed more  and more the fymptoms of the nervous
 kind ;  the  pulfe became lefs frequent, foft,  and feeble; and fome-
 times even flower than,in a ftate of health ; the  face  much lefs
 flufhed,  the  features more tranquil, with a deadly  afpedt of the
 countenance, or fometimes it was but little altered.  The fuffufion
 of the  eyes frequently increafed ; the heat became confiderabty

  ■*  It may not be improper to obferve, that for feveral weeks after the
contagious fever made its appearance in Philadelphia, intermitting 3nd
remitting fevers were met with at a fhort diftance from the pUce whtr«
the malignant fever was fpreading its ravagest 
»5<>
OF  THE YELLOW FEVER.
diminifhed, and in Some caSes, leSs than in a ftate of health; fkia
cool,  Sometimes with a ckmmy moilture on the face, neck, and,
back of the hands ; the fickneSs at ftomach increaSed with a burn-
ing SenSatioi: in the region of  it, and continual vomiting of frothy
matter; at other times it was bilious., ftreaked with blood. Intheiev
male fex, if the menfes did not  flow at their ufual period, there was
generally a quantity of biood brought up by vomiting, accompanied   M
with violent Stricture about the prsecordia, and a fenfe oS weight*   ',
with great flatulency in the ftomach,. and the inteftines, which was
very diftrefling; Sor they were generally coftive, and had not ener-
gy Sufficient to expel  the wind either upwards or downwards. The
tongue in  this ftage trembled much; and with refpect to colour, it
was Variable ; in  the  Sormer, often nearly natural, at other times
covered over with mucus verging towards  black, particularly in the   |
middle ; Sometimes dry, but generally moift, and not4infrequently
of a florid colour.  It appeared as if rubbed over  with  the red
particles of the blood, with deep furrows in it or chopped.  When
the patient was defired to put it  out of  the mouth,  he would
continue it until he was told to draw it in.  The  thirft was muck
augmented, with  a continual  drynefs of the lips and fauces. The
confufion  of the intellects increaSed to  a complete delirium ; the
reftleffneSs became truly diflreffing, and the patient almoft outra-
geous, and in fome cafes maniacal.
   The fkin and eyes affumed a deep yellow colour, with the Same  .
appearance in the urine, which was Small in quantity, and difchar-   |
ged with difficulty.  When the fkin was not fuffufed, the urine was
turbid, depofiting a  deep  browm fediment.  The  refpiration was
flower than natural, except whsn the body was much agitated by
Liie extreme r.elt!eflhefs, accompanied with heavy fighing, and much   j
debility in all the moving powers  of the body. The patient gene-
rally lay on his back, with his Seet drawn up towards his body; ne-
vertheless, he had Sufficient pewer, when urged by the call of Na--
ture,  to riSe Srom his bed.
   In  the decline of this ftage, the  fkin was fometimes covered over
with  petechial eruptions, appearing like the flings of nettles, of a
dark-red colour, principally about the neck and breaft, accompa^
nied fometimes with haemorrhages from diflerent parts of the body v
but thefe fymptoms more particularly belong to the third  andlaft
Stage. The1 duration of the fecond ftage was various* generally ac-
cording to the violence of the fymptoms  or to  the duration and
Severity of the preceding ftage. It feldom lafted longer than fifty
or Sixty hours before death took place, and Sometimes without the
occurrence of many of the fymptoms-of the laft ftage.
   This ftage generally commenced with the pulfe becoming very
feeble intermitting,  and  almoft imperceptible at  the wrift; fee-  ,
quently not more than thirty or thirty-five  Strokes in  a  minute.
There was alfo a great diminution of the  heat of the  whole body,
except about the prxcordia, which feejned,  if the expreffion may 
             OF  THE  YELLOW  FEVER.          *57

be ufed, to be mere tenacious of its heat than any ctl:er part of the bo-
dy, and was the laft part that furrendered it up after death.
   The fkin became much cooler, and covered univerfally with at
clammy moifture ; the countenance exhibited a deadly afpect; the
eyes lefs painful, but fo dreadfully fuffufed, as fometimes almoft  to
obliterate die colour of the tunica albuginea,\vith great twitching of
the mufeles of the face, and general flartiugsof the tendons through-
out the body. The petechias increaSed, and became oSa purplifh co-
lour, between which the fkin was of a deep yellow; great delirium,
with continual reftleffneSs fucceeded.  The patient lying principally
on his back,the powers not being Sufficient to retain him on his fides;
the feet were generally drawn up, the  whole body Srequently Ai-
ding down in bed. The vomiting increaSed, and  the  matter  ejec-
ted was oS a dark colour,  refembling coffee-grounds, Sometimes
mixed  with  b.lood*.  The  Sollowing were  uSual appearances;
viz. great flatulency; hxmorrhagies Srom the different parts of the
kody;  tongue frequently covered over with blood, and of a florid
colour; at other times black and  dry ; urine very offenfivc; Some-
times a total fuppreffion of it, and when Stools were procured, they
were extremely black and feetid; livid ulcers in  the mouth; and
the parts where blifters had-been applied, affumed a black afpect -%
laborious and deep refpiration, with heavy fighing and great op-
preffion at  the prsecordia ; faultering in the fpeech ; cold and livid
extremities;  involuntary difcharges of the feeoes;  lofs of Swallow-
ing; coma; eyes glazy. Startings and convulfions frequently cloSed
the Scene.
   TheSe were the appearances of the malignant fever through its
feveral ftages.  Although in its firft attack it was frequently much
varied. Sometimes the patients were  feized of a fudden, at other
times in  the manner above  defcribed ; but often, in its different
ftages, it was much diversified, according to the violence and du-
ration  of the Symptoms, to the age, Sex, and conftitution oS the
patient.   In Some,  the  diSeaSe terminated  in death,  during the
inflammatory period;. in others, it was hurried  So precipitately
through  the ftages, that they could hardly be discriminated by the
moft accurate obServer,  beSore the patient's fate  was determined.
In other cafes,  it paffed with fome degree of  regularity, as above
marked ; and the diflolution pr recovery ,was protracted'to an un-
common period. -  This was particularly the cafe in  thofe  peo-
ple who laboured  under a  fevere Salivation  from the effects  of
mercury. In judging concerning the  event of the malfenant fever
during its firft ftage, the danger was generally in proportion to the
degree of inflammatory action. Of this an idea maybe formed from
the violence and duration of the fymptoms.

  •K From the experiments I have made on the black matter or vomit, i *:
feemed to have fcarce any of the properties of putrid bKe or blood ; bur.
appeared to be a difeafed fecretion from the liver, poffefling but little ac-
tivity when applied in.any form to an healthy human fyltera.  (I.  C.) 
'i55         OF THE YELLOW FEVER.

   The febrile affection, when very confiderable, was demonftra*
 ted  by the viofent pain  in the head and back, great fuffufion of
 the  face and eyes, with obvious distortion oS the features ;  nau-
 fea  and  vomiting, with a fenfe of univerfal forenefs, particularly
 in, the limbs. The danger was then imminent.
   When the inflammatory ftage was of ihort duration and of great
 violence, accompanied with un'ufual quick refpiration, heavy figh-
 ing, and great' oppreflion at the  prsecordia from the commence-
 ment, together with great reftleflhefs, conSufion of the intellects
 and deep defpondency of mind, with a dread of fpeedy diflblu-
 tion, they  were to be confidered as very unfavourable fymptoms.
   When very great proftration of ftrength, or a fpontaneous di-
 arrhoea,  appeared after bleeding,  without manifeft relief to the
 patient,  they were generally unfavourable fymptoms ;  indicating
 danger in proportion to their violence.
   Should a yellow tinge in the eyes and  fkin  appear, which is
 merely an  accidental circumftance, although it has been confider-
 ed, by fome of the  tropical writers,  as an unfavourable appear-
 ance ; by others, as expreffive of  the crifis of the difeafe; my ex-i
 perience does not corroborate either the one or the other, but I
 am induced to confider it as a favourable, rather than an unfavour-
 able occurrence.  Should the retching and vomiting be much in-
 creafed,  with dark or coffee- coloured matter ejected, death gene-1
 rally enfued-
   Fatality commonly happened  on the fourth or  fifth  day;
 in fome cafes, on the twelfth, and even on the twenty-fourth and
 twenty-fifth day.   But thefe patients,  in addition to the difeafe,
 often  had  a fevere Salivation  from  the administration of large
 quantities of calomel during their indifpofition.  The Salivary dif-
 eharge,  in all probability, protracted life.
   A favourable prognofis may be formed in this ftage of the dif-
 eafe, from the febrile fymptoms being more moderate, together
 with the abfence  of feme of thofe before-mentioned ones, parti-
 cularly the fuffufion of the eyes, fighing and vomiting, efpecially
 if a flight Ivaemorrhagy takes place from the noftrils, with erup-
 tions about the mouth, a flight cough, and an expectoration  of
 yellowifh matter, with bilious evacuations by Stool,  particularly if
 they afford relief  to the patient, together  with the  formation of
 abfeefles in different parts of the body. Thefe are frequently, at-
 tended with an abatement of almoft  every other  fymptom, and
 the patient recovers.
   In the Second Stage: If the  pulfe  became very feeble, fmall
 and  iatermitting,* with a confiderable diminution oS heat below
 the natural ftandard, exceffive vomiting, with great burning in the
 region of the ftomach, particularly if the matter ejected be black,

  ■*  In elderly people, I have found the pulfe intermitting in feveral
 cafes, and they always recovered. 
              OF  THE  YELLOW  FEVER.         i59

 which was frequently the cafe, the patient  had but a fhort time
 to live.
   There was little information to be acquired in any period of this
 difeafe,  from the appearance of the urine, but when jt was dark
 and fretid,  the patient delirious, troubled much with  flatulency,
 great fuffufion of the eyes, a  deadly afpect  of  the countenance,
 with vomiting of blood, which frequently occurred in the feniale
 fex, when their menfes did not  flow  at the ufual period, and
 wlien it happened to women at the period of life when they become
 extremely irrregular, and generally ceafe to flow,  the prognofis
 will be found very unfavourable.  At that time of life, the fyftem
 undergoes a very material  change,  being about to  accommodate
 itfelf1 to a new mode  of action. It is Scarce ever  able to withftand
 this, with the violence  of  fo dreadful a difeafe.
   When the tongue was florid, appearing as if  rubbed over with
 the red particles of the blood,  accompanied with a clammy moif-
 ture  on the different parts of the  body, refpiration  laborious,
 with fighing and livid petechia? generally fpread  over the  fkin,
 the parts where bliffers  were applied becoming of  a dark colour,
 together with the pofture of the patient's body indicating great
 debility, with difficulty in making water, although the pulSe be at
 the Same time tolerably even and ftrong, which is not unfrequent-
 ly the caSe,  they are marks of extreme danger.
   A favourable prognofis in this ftage, as well as in the preced-
 ing, does not depend on a Solitary  favourable fymptom,  but on
 feveral;  therefore we fhould be guarded in giving an opinion.
   IS the pulSe, Srom being extremely Seeble, fliould acquire more
 Strength, and the heat, which was before  considerably diminifhed,
 becomes in general nearer the healthy ftandard,  together with an
 abatement of the  violent vomiting and burning fenfation in the re-
 gion of the ftomach and prsecordia, the brain  lefs confufed,* with
 a diminution of reftiefTnefs and ceflation of  fighing, gradual dis-
 appearance of petechise, with an enlargement in and  about the
 parotid glands, disfiguring much the natural form  of the vifage,
 occurring particularly in children, fometimes  in adults, the tongue
 becoming cleaner from  the middle  and poinr, towards the edges,
 the patient capable of lying in any pofition with  tolerable facility,
 with incipient formation of abfeeffes in different parts of the bo-
 dy, and a flight return of appetite,  although  the fkin and eyes be
 of a deep yellow  colour, we may prognosticate with Some  degree
 of certainty, that the event will be favourable.
   In the laft ftage : This may  be confidered as only  a  deeper
 Shade in the fymptoms of the latter part  of the fecond, with the
 addition of  others,  but replete with danger.
   Nevertheless, with all the difagreeable fymptoms of fighing, yel-

  *  If the patients became maniacal, the difeafe generally difappeared,
gnd they frequently recovered.. 
OF  THE  YELLOW  FLYER.
 iownefs of the fkin, delirium,  black vomiting,  livid ulcers in the
 mouth, fphacelation of bliflered parts, bleedings  from the noSe
 and mouth, black tongue, and almoft every other Symptom that
 this ftage can produce, excepting a remarkable Seeble and  inter-
 mitting pulSe, I have Seen Several patients perfectly recover. The
 change  generally  took place Sor the better  on the  ninth or tenth
 day, on which  the pulSe became more  full,  ftrong and  even,   ,
 intellects leSs confufed, tongue more florid from the middle to-
 wards the ed^es, heat general,  and more equally  diffuSed,  ceffa-
 rion of vomiting and haemorrhagies, bowels more regular, with a
 flight return of  appetite, and beginning abforption of the yellow^
 nefs and petechia?, with a capability in the patient of lying in any
 pofition,  with increasing ftrength and complete recovery.  Thefe
 inftances were very rare, though few will deny their occurrence.
   REGIMEN.----The patient fhould abftain from animal food ;
 and when any thing is required, it fhould be gruel, panada, &c.
 He Should uSe cool diluting drinks, Such as barley-water, applet
 water, with Small quantities of ripe fruits, which tend to keep the
 bowels open. The  chamber of the fick fhould be fpacious and airy,
 kept cool, and frequently fprinkled with vinegar.  Great attention
 Should be paid to. thefe circumftances,  as they are of infinite im-
 portance to thofe who frequent the apartments of the fick, and are
highly conducive to the cure of the difeafe."
   MEDICINE.----In the cure of the malignant fever, it appeared
■neceffary ; firft, to moderate the  inflammatory action :  fecondly, td
remove or alleviate certain  diftreffing  fymptoms which generally
 occurred, more or lefs,  through the feveral ftages of the difeafe:
 thirdly, to fupport the tone and  vigour of the fyftem.
   The inflammatory action was moft effectually moderated by the .1/
different clafles of evacuants;  among  the  molt efficacious  was  !j
bleeding in the arm.                                             1
   About the tenth of Auguft, 1793,  which was fhortly after the
difeafe made its appearance in Philadelphia, bleeding was not at-
tended with fuccefs, at leaft among  the fick under my care; there-
fore, the practice was difconfinued; and I trufted, with moft of my
medical brethren, to the milder clafs  of evacuants, until the 12th    J
of September. Having found, on diffection, the ftomach and intef-  :
tines highly inflamed,  I reSumed the  practice of bleeding upon  ■*
good grounds, and with evidently better effect.  The  quantity of '<
blood to be taken  away was  regulated  by  the violence of the
fymptoms, age,  fex,  and  habit of body ;  for thofe  who  were
very corpulent did  not bear evacuations near fo well as' thofe of'a
Spare make.  No certain rule can belaid down, with  refpect to
the quantity of blood to be taken.   The  attempt muft be  fubject
to confiderable error;  yet the number of ounces to be abftratted
has been dictated by Some  authors.  Dr. Williams, of Jamaica,   '
who wrote in 1750, advifed plentiful bleeding.  Dr. Hillary, of
Barbadoes, bled  once or twice  during the firlt days  of the djf* 
             OF  THE  YELLOW FEVER.         161

safe*.  Dr. MoSely inSorms us,  that bleeding Should be perform-
ed and repeated every fix Qr eight hours, and if the fymptoms be
obflinate and do not abate, it Should be executed even to fainUngf.
Dr. Blane obServes, that iS the patient had not a throbbing pulfe,
with violent pain in the head and back, it fhould not be perform-
ed ; and that without the  prefence of thofe fymptoms it was ex-
tremely dangerous.  Dr. Warren, who had paffed a confiderable
time in Barbadoes, feems much  averfe to  bleeding  in  any ftage
of this difeafe.   Such  are the different opinions  of the tropical
writers on this fubject.  But during the prevalence of the malig-
nant fever in Philadelphia, which nearly refembled that defcribed
under the appellation of the putrid bilious fever of the Weft-India
iflands, I was influenced in the  abstraction oS blood,  by the ten-
sion and SulneSs oS the  pulSe, the SeaSon of the  year, and other
circumftances previoufly obServed,  together with  the  abatement
which the fick experienced of the fymptoms during the flowing of
the blood.  But it was very feldom that one  bleeding, however
profufe it may have been,  would put an end to this difeafe ; al-
though the  pains in  the head and back were greatly mitigated.
Yet they too often returned with  additional violence.  At  this
time, if the pulfe continued full  and tolerably  tenfe,  and the
ftrength not much impaired, a fufficient quantity of blood may be
taken away to procure an alleviation of the fymptoms. This fhould
be repeated as often as they recuij in the inflammatory ftage oS the
diSeaSe ; but it Seldom appeared neceffary to be done later than the
end of the third day.  When it was employed at  a  more advan-
ced period, particularly near the time when the difeafe was palling
into its fecond ftage, it invariably  increaSed the train oS terrible
Symptoms which mark this period, with a Sinking in  the  pulSe
that no human effort was able to Support.  The blood drawn in
this ftage oS  the diSeaSe, very Seldom  perfectly Separated  into the
watery and groffer parts.   When it did, the former was of a na-
tural colour, though fmall in quantity in proportion to the latter.
The thicker part was generally of a florid arterial colour, tender
in the courfe of  the warm weather.  As the cool  weather advan-
ced, and the difeafe  became more inflammatory,  it  was fizy in
fome cafes,  with a proportionable degree of contraction of its fu-
perior circumference, exhibiting  a cup-like  appearance.'  Some-
times, during the warm v/eather, there was a thick tender fizycoat
on its upper /urface, vyithout  this cup-like  appearance.   When
blood was drawn during the yellow fuffufion c£ the fkin, the thin-
ner part was of a corresponding colour, yet not in the leaft bitter
to the tafte, that could bz obServed  in a variety oS  inftances;  and
was, hke healthy Serum, affected by heat and acid's. To return to
the cure : At the Same  time that great attention was paid to blood-
letting, other remedies were not  neglected.  Whatever ccntri-

    %  Hillary's Obfervations, pnge 157.   t Mofely, page 4-9. 
 162         OF  THE YELLOW FEVER.

 buted to diminifh the quantity of  fluids in the fyftem, and carried
 off the redundant matter in the firft paflages, was proportionably
 efficacious in diminifhing the inflammatory action.  Purges, and
 other evacuants, were employed,  as  being  Secondarily  the moft
 powerful remedies, particularly when alternated  with  bleeding,
 which appeared to be the moft judicious  way  of  ufing  them.—
 Thofe preferred were fuch, on whoSe powerful action, reliance
 could be  had,  and  when  the  ftomach was fick, ■ required but a
 fmall quantity  to anfwer  the  purpofe, at the  fame  time beirig
 agreeable to the palate.  Calomel poflefies  moft oS thofe proper-
 ties, and under certa:n circumftances, could be adminiftered with
 the greateft advantage.  It fhould be  given in large doles until it
 has the defired effect, and  might be expedited in its operation by
 giving laxative clyfters.  When  the  functions of the  ftomach
 were not much ^deranged, which was fometimes the cafe,  the  fa-
 line purgatives  were made vSe  of,  fuch as Glauber fait, which were
 powerful, lefs flimulating than the calomel, and of courfe, better
 antiphlogifties.  Thefe anfwered the purpofe equally  well,  as  the
 object was merely to reduce the energy of the fyftem and carry off
 the bilious matter;
   To relieve the violent pain in the head,  blifters were employed,
 after general4 evacuation had been ufed as far as appeared- advifa-
 ble; but pre\ious to their application to the neck, blood was draivn
 by the part to.be blift.ered.This mode of practice generally afforded
 confiderabfe reli=S.                                 «
   Having taken notice oS remedies Suitable to the firft indication,
 I come now to the Second,  viz. to alleviate or remove certain dif-
 treffing fymptoms ; fuch as violent vomiting, coftivenefs, flatulen-
 cy, great reftleffnefs vlnd want of fleep, and  alfo to  the means ufed
 to divert the defpondency  of the pariem.
   To moderate the exceffive vomiting, often baffled  every prac-
 titioner.  Various means were employed to  effect it;  which may
 be divided into external and internal. Among  the former, was
 blistering the different parts of the body,  particularly  the  region
of the ftomach. From repeated trials, it feemed  to  have but little
influence on the latter.   Blifters have been recommended  to  be
 applied to the legs by Dr. Hume, of Jamaica, from which  he ex-
 perienced very good effects.   This practice appeared  here only
 to torture the patient's feelings, without the leaft  abatement of
 the vomiting.  Warm bathing  was employed in  this-ftage  of the
 difeafe, Sometimes with a  mitigation oS the vomiting ;  yet Sre-
 quently it increaSed the fickucSs  at the* ftomach,  and  produced
fainting. Flannels wrung out of a warm and Strong infufion of aro-
matics, applied, conftantly to  the region  of the  ftomach, were
fometimes Serviceable ; but external applications feldom  promifed
much advantage.
  With refpect  to internal remedies, almoft  every anti-emetic was
employed, that the experience of phyficians had found ufeful, but 
OF  THE YELLOW FEVER.
irj3
frequently without having the defired ejfect;  fuch  as the faline
mixture in the ftate of effervefeence; the infufion of columbo root,
cinnamon water-with liquid laudanum; the peppermint julep with
laudanurh,as alfo barley-water, toaft-water,apple-water,lemonade,
camomile tea, and a variety of other drinks  during the inflamma-
tory period. After thefe, fmall dofes of tincture of Peruvian bark,
with fpirit of lavender-compound, were  adminiftered with a
good effect, paticularly when the fymptoms of violent inflamma-
tion of the ftomach did  not contra-indicate  its ufe.   It was efpe-
cially Serviceable to fuch patfents who bad been accuftomed to an
irregular mode of life,  and drank to excefs of Spirituous liquors ;
for, when every other article was immediately rejected, it generally
continued on the ftomach.  The mucihginou5 vitriolic mixture'*
was ufed to advantage, and f nail quantities of wine, porter,  cy-
der, or brandy and water, .was of fervice, by giving tone  to  the
debilitated ftomach.
   Frefh buttermilk was frequently found grateful to the fick,  and
very b mefkial as an anti-emetic, even when Srom the SymptomF, it
 might be concluded, that the ftomach was highly inflamed.  Like-
wife, a tea-fpoonful of cream-tartar, diflblved in Sugar and water,
was known to flay on the ftomach and pals through the bowels,
when svery other medicine and  drink was inftantly rejected. This
 medicine was adminiftered  with a  view to  remove coftiveneSs,
which fhould always be guarded againft in this difeafe ; but the
 patient finding it So effectual in  flopping vomiting,  he frequently
 had recourfe to it without being coftive, with the fame good effect.
 In feveral other cafes it was made uSe  of, but was too often in-
 ftantly rejected. Caftor-oil, adminiftered under  Similar circum-
 ftances, had the like  cffecY; but this was not often the cafe, al-
 though I have frequently known it to continue on the ftomachs of
 people violently fea-fick,  and remove coftivenefs, when drink of
 every kind was immediately thrown up.  During  exceffive fick-
 nefs at the ftomach, the moft agreeable medicine and drinks were
 leSs Srequently rejected  than thofe of an  unpleafent quality.  No"
 fooner did a draught of any.fiquid reach the ftomach, than it was
 inftantly rejected.lt is not to be apprehended that this arofe from
 the quality,  but rather  from the quantity.  On this account, the
 patient fhould not take more rhan a table-fpoonfui at a time.  His
 own feeling, with refpect to fulnefs and ficknefs at the ftomach,
 ShouM determine the frequency and quanticy of drink, however
 infatiablv thirfty h"? may be.  In conjunction with  thefe  precau-
 tions, the body fliould  be kept as quiet as  poffible ; Sor the  leaft
 accelerated motion  of  it, frequently brought on a fit of vomiting.
    CoftiveneSs and flatulency were  extremely diftreffing  in  this
 difeafe.    To remove them was always very difficult, particularly
 when there was much ficknefs  at the ftomach, with vomiting; Sor

  6 Which is mucilage of gum-arabic, acidulated with elixir of vitriol. 
164          OF  THE  YELLOW  FEVER.

the inteftines were Srequently very fluggifh in  their  action^and
the ftomach generally rejected every claSs of purgative medicines.
When this was the  caSe,  there  was no alternative  but that of
keeping the bowels open by clyfters.  Thefe werefttbject to confi-
derable inconvenience, when they could be adminiftered ; but this
was not often the cafe.  They frequently cleared but  the lower
part of the  inteftines, whilft thofe  approximating the  ftomach,
 were  generally diftended with  faeces* and  an inceffant  Source of
irritation to the ftomach. Whenever, thereSore, a chance oS Succefs
in the administration of purgative medicines occurred, they were
always attempted.   They generally cleared  the whole tract of in-
teftinal canal, and frequently procured a mitigation of  the vomit-
ing.  If rejected, they were not frequently repeated, left they might
exhauft the ftrength of the patient without contributing  to his
relief.  Keeping the inteftinal canal clear of feeces, in fome mea-
fure, obviated flatulency.   But in an advanced  period of the dif-
eafe,  the ftomach and  inteftines were  fo much debilitated, that
they frequently had not energy  fufficient,  when apparently clear
of faeces,  to expel the wind either upwards or  downwards, but
it continued, as it were,flationary, and tormented thepatient.  Dur-
ing this ftate, when the ftomach was tolerably tranquil, a ftrong in-
 fufion of fennel-feed was  adminiftered,  mixed  in a fmall quan-
tity of brandy, with advantage,  particularly wdien alternated with
Some  agreeable tonic,  fuch  as the mucilaginous vitriolic  mixture
already recommended, if nothing  contra-indicated  its ufe,  or a
fmall  quantity of  a ftrong  infufion of fpices.  They fometimes
 afforded relief; but thofe fymptoms too frequently  baffled  every
 attempt to remove them.
   Another  circumftance was, the extreme reftleffnefs and want of
 fleep.  Generally, by quieting  the former, the fatigue from the
 long  wakefulnefs  will Srequently induce the  latter.   This indi-
 cation was moft effectually anSwered  by opium.  The propriety
 oS employing it,  has engaged the attention oS  many oS the tropi-
 cal writers.  By one it is much approved oS ;*' by another it is
 condemned during the inflammatory period, as being  highly lti-
 mulating and acrid.  The uSe oS it, Says one, muft be attended
 with  imminent dangerf.  In  the Subsequent  ftages, good effects
 h.ve  been experienced Srom the ufe of opium, particularly in the
 fecond 3nd laft ftages of the difeafe.  In the  former it induced fleep,
 refrefhing thepatient, and enabling him, in fome meafure, to refill
 the extreme violence of the difeafe.  Iq the Litter, it afforded confe-
 lation by lulling the inquietude, and Smooth: ng the avenue to death.
   To divert the   gloomy thoughts  of the  patient, was attended
 with  almoft infurmountable tiiuiculties.  Hov, ever,  it fhould  be
 always attempted by the molt  encouraging  language «nd  aflur-
 ance  of a complete recovery ;  for on this, the favourable termi-
 nation of the difeafe much  depends.   The patient  fliould  not be
        -*  Hillary's Obfervation:^  page i(o.    f Dr. ".'ofely. 
            OF THE  YELLOW FEVER,          165

told that he has the yellow  fever ;  for I  have known  a patient,
in this difeaSe,  faint from an unguarded expreffion, and afterwards
die  apparently  from a flight  attack. No art could perfuade him that
his  diflblution  was not approaching with hafty fpeed.  ThereSore,
greatcircumSpectionfhouldbe obServed, and the patient encouraged
with as much  confiftency and boldneSs as poffible. Moft of the fick
that were Slightly indifpofed, would feizc the leaft dubious expref-
 fion of the phyfician, refpecting their* recovery.
   I come now to the third  and laft indication ; which is,  to fup-
port theTinking tone and perifhing vigour  of the fyftem.   This
indication is applicable to the feeond,  but more particularly to the
laft Stage of the difeafe.  The latter, being an augmentation of the
fymptoms of  the  former,  fometimes much  diverfified, requires
 more powerful remedies.   Whenever a change  was perceived in
 the fyftem, indicating tfeat debility was commencing, the nature of
 the difeafe muft be confidered  as   materially. different,  conse-
 quently requiring  a particular mode of treatment. The patient
 Should not be reftricted to  a vegetable diet or watery drinks, espe-
 cially if there are  no violent fymptoms indicating inflammation
 of the ftomach.  Stimulants fliould   be employed both external
 and internal,  fuch as blifters to cifferent parts of the body, in or-
 der to excite  the  fyftem.  The application, when deferred to a
 more advanced period,  wasr?therof differvice; for the ftrength
 oS the patient  was  So far exhaufted,  that  the  bliftered  parts
 Soon  became  black  and  Sphacelated, Sometimes  attended  with
 proSuSe tasmorrhagy.    Their application was difcontinued  in
 the laft ftige  of the difeafe.   Wafhing the whole body in .brandy
 and water, or when that could not  be complied  with, the Sace,
 breaft and h;>nds, always proved very reSrefhing to the  fiek ;
 cold  water  thrown over  the  head  and fhoulders, morning and
 evening, frequently had  a good effect, by giving vigour to the fyf-
 tem.  It likewife invariably induced  fleep,  with a gentle moifture
 on the fkin.   In addition to the external ftimulants already men-
 tioned, muftard poultices maybe applied to the feet; and when there
 are no fymptoms contra-indicating  the ufe of  internal remedies,
 Such as violent Symptoms  oS inflammation in the ftomach, they
 Should be adminiftered ; and one would imagine, Srom the declin-
 ing vigour oS the Syftem,  that bark  and wine would  be uSeSuh*
 The  former  oS which, in  Some cafes, was Serviceable,  particularly
  when the functions oS  the ftomach  were not much deranged ; but
  nauSea and vomiting were So invariably preSent, that in almoft all
  caSes, in whatever manner or Sorm  it was  adminiftered, it always,
  at leaft in my practice, proved detrimentalf.  This efpecially hap- ,

    or-  The intermittent and remittent fevers, mentioned in a note in the
  hiltory of this difeafe, were cured by emetics and the bark ; the,latter
  continued very well on the ftomach.
    t  fxeept to ufe it in fmall dnfes to quiet the perturbed ftomach, giv-
  en under the  circumftance"  formerly meutioacd. 
166         OF THE  YELLOW  FEVER.

pened, when the bark was given by the mouth.   It commonly
deranged the ftate of the ftomach in' fuch a manner,  that it  was
not fufeeptible of retaining any other medicine or drink.   When
adminiftered in the form of clyflers,  mixed with London porter
and laudanum,  it did not feem to have any good effect. They ge-
nerally produced a painful fenfation over the whole abdomen. This
was fometimes the cafe, even when a  common laxative clyfter was
given, fo that t*he patient could fearccly retain it a moment. Dur-
ing the time bark was employed, wine was given, beginning with
claret or any other weak wine ; but if there was great  defect in
the vigour of the  fyftem, Madeira was foon found  neceffary.   If
wine  could not be taken by the patient,  brandy, diluted with wa-
ter,   porter, or cyder, was  fubftituted.  Thefe fliould  be  in-
creafed in quantity, according to the  ftate oS the ftomach and de-
gree of feeblenefs in the pulfe, at the fame time the elixir of vi-
triol was employed as a ionic.   The bark,  the  moft powerful  of
all tonics, was ftuudtodifagrce with the ftomach, and was there-
fore always omitted, except during the convalefcent ftate, and an
entire dependence was placed  in the medicine  recommended,  to-
gether wiih the wine or its fubftitute..  Thefe fhould be adminif-
tered in large quantities, nnd continued,  until the pulfe, from  be-
ing fmall and finking, became full,  round,  and tolerably ftrong;
the heat more equally diffufed, the delirium abating,  and the pa-
tient becoming more  cheerful.  Such were frequently the  effects
of thofe ftimulants ; and even when the  ftrength appeared almoft
exhausted, they would revive and keep up the  Spark of iife,  and
fometimes in the moft deplorable cafes, reftore perfect health and
vigour.
  Great caution fliould.be obferved in the adminiftration of wine.
When the  moft urgent Sympioms  are  mitigated,  and Some  of
them removed, the quantity may be gradually diminifhed. Should
the dangerous Symptoms return, it may be augmented with cau- '
tion.   This practice was more expedient iS the patient could take
Some nourifhment that was light and agreeable, Such as panada, or
gruel; or iS there was a  flight  return of appetite, fome preparation
of animal food fhould be given, fuch as weak broth, and at times
a few oyfters, if the ftomach wcui'bear them.  Great caution was
to be obferved in making ufe of folid food. If any is advifable, oyf-
ters certainly are the moft proper, as they are the moft eafy of  di--
geftion, and afford a fufficient quantity of nourishment.
  It  is proper to  take no;icc  of the conduct to be obferved  by
the patient during the convalefcent ftate. This was  generally  te-
rfious.  When the difeafe had been remedied  by proSufe evacua-
tions,  the recovery was  confiderably  protracted and  precarious.
The patient  acquired ftrength  but flowly, and  fometimes  had  a
tendency to afcites.  During  recovery,  patients fhould be very
circumfpect in their conduct,  for fear of  a relapfe of fever. They
fhould checfe food mcft  eafy  of digeftion; eat moderately;  and 
                 OF  THE SMALL-POX.            167

 take a dofe of bark, two or three times a-day,  to affift digeftion,
 and invigorate  the  debilitated dropfy.   A moderate quantity  of
 wine may be allowed ;  gentle exercife  fhould  be  conjoined, the
 bowels kept open, and the night-air avoided.



                CHAPTER  XXIV.

                     Of the Small-Pox.   l          »   '

      THIS difeafe, which originally came Srom Arabia, is now be-
       come So general, that very few efcape it at one time of life or
 another. It is a moft contagious malady ; and has  for many years
 proved the feourge of Europe.
   The  fmall-pox generally appears towards the Spring.  They are
 Srequent in Summer, leSs So -in autumn, and leaft oS all in  winter.
 Children are moft liable to this diSeaSe ; and thoSe whoSe Sood is un-
 wholefome,  who want  proper exerciSe, and abound with  groSs
 humours, run the greateft hazard Srom  it.
   This diSeaSe is diftinguiflied into the diftinct and confluent kind ;
 the latter of which is always attended  with danger.  There are like-
 wife other diftiuctions of the fmall-pox ;  as the  cryftaliiue, the
 bloody, Sec.
   CAUSES.----The fmall-pox is commonly caught by infection.
 Since the difeafe was firft  brought into Europe, the infection has
 never been wholly extinguifhed, nor have any proper methods, as
 far as I know, been  taken for that  purpofe ; fo that now it  has be-
 come in a manner conftitutional. Children who have over-heated
 themfelves by running, wreftling, &c. or adults after a debauch, are
 molt apt to be Seized with the Small-pox.
   SYMPTOMS.----This diSeaSe is So generally known, that a
 minute description of it is unneceffary.  Children commonly look
 a  little dull, feem Hftlefs and drowfy  for a few days before the
 more violent fymptoms  of the fmall-pox appear.   They are more
 inclined to drink than ufual, have little appetite for folid food, com-
 plain of wearinefs, and, upon taking exerciSe, ate apt  to Swcn*.
 Thefe are fucceeded by flight  fits of cold and heat in turns, which,
 as the time of the eruption approaches, become more violent, and
 are accompanied with pains of the head and  loins, vomiting, &c.
 The pulfe is quick, with a great heat of the fkin, and reftlefihefs.
 When the patient drops afleep, he wakes in a kind  of horror, with
 a fudden ftart, which is a very common fymptom of the approach-
 ing eruption ; as are alfo convuliion-fits in very young children.
   About the third or fourth day from the tiftie of Sickening, the
 f nall-pox generally begin to appear; Sometimes they appear  Sooner,
 but that is no favourable fymptom. At firft  they very nearly refem-
ble flea-bites,andarefjonett discovered on the face, arms,and breaft.
   The moft  Sa. ourable Symptoxs are a flow eruption, and an abat-e- 
 168              OF THE  SMALL-POX.

ment of the fever as foon as the puftules appear.  In the diftinct
kind of fmall-pox, the puftules feldom appear before the fourth day
from the time of fickening, and they generally keep  coming out
gradually for feveral days after. Puftules which are distinct, with
a florid  red bafis, and which fill with thick purulent  matter, firft
of a whitifh, and aSterwards of a yellowifli colour, are the beft.
   A livid brown colour of  the puftules is an unfavourable fymp-
tom ; as alfo when they are fmall and flat, with black fpecks in the
middle.  Puftules which contain a thin watery ichor are very bad.
A great number of pox on the  face is always attended with danger.
It is likewife a very bad Sign when they run into one another.
   It is  a moft unfavourable fymptom  when petechias, or purple,
brown or black fpots are interfperfed among the puftules. Thefe
arfe figns of great danger.  Bloody flools or urine, with a Swelled
belly, are bad fymptoms; 'as is alfo  a  continual Strangury.  Pale
urine and a violent throbbing oS the arteries oS the neck, are figns   ,
of an approaching delirium, or of convulfion-fits.  When the face
docs not Swell, or Sails beSore the pox come to maturity, it, is very
 unfavourable.  If the face begins  to fall about the  eleventh or
 twelSth day, and, at the Same time,the hands and Seet begin to Swell,
 the patient generally does well;  but when  theSc  do not Succeed to
 each other, there  is danger.  The tongue  covered with a brown
 cruft is an unSavourable Symptom.   Cold fhivering fits coming on
 at the height of the difeafe are likewife unfavourable.  Grinding
 of the teeth, when it proceeds-from an affection  of  the nervous
 fyftem, is a bad fign ; but fpmetimes it is ocdafioned by worms, or
 a difordered ftomach.
   REGIMEN-----"vyhen  l^e firft  fymptoms of the fmall-pox ap-
 pear, people are ready to be alarmed,  and often fly to the ufe of   i
 medicine, to the great  danger of the patient's life. I have  known
 children to be  bled, bliftered  and purged, during the Sever which  . J
 preceded the eruption oS  the Small-pox, to Such  a  degree, that  il
 Nature was not only disturbed in her operation, but rendered un-  m
 able to fupport the puftules alter they were out;  fo that  the pa-
 tient, exhaufted by mere evacuations,  funk under the difeafe.
   When convulfions appear,  they give a dreadSul alarm.  Imme-
 diately Some nottrum is applied, as if this were a primary diSeafe;
 whereas it is only a Symptom, and Sar Srom being an  unSavourable
 one, of  the approaching eruption. As  the  fits generally go off be-
 fore the actual appearance of the fmall-pox, it is attributed to the
 medicine, which by this means acquires a  reputation without any
 merit*.
   • Convulfion-fits are very alarming ; but their effects are often falutary.
 They feem to be one of the means made ufe of by "Nature, for breaking
 the force of a fever. I have always obferved the fever abated, and fome-
 times quite removed, after one or more convulfion-lits.  This readily ac-
 counts for convulfions being a favourable fymptom in the fever which
 precedes the  eruption of the final!-pox,  as every thmg that mitigates
 this fever lelfens the eruption. 
                 OF THE SMALL-POX-             169

  All that is, generally Speaking, neceffary, during the eruptive fe-
ver, is to keep the patient cool and eafy, allowing him to drink
freely of fome weak diluting liquors; as balm-tea, barley-water,
clear whey, gruels,  &c. He fliould not  be confined  to bed, but
fliould fit up as much as he is able, and  fhould have his feet and
legs frequently bathed in  lukewarm water.  His food ought to be
very light; and he fhould be as little.difturbed with company as pof-
fible.  Much miSchief is done at this period, by confining the patient
too Soon to his bed, and plying him with warm cordials or Sudorific
medicines. Every thing that heats and inflames the blood, increaSes
the fever, and puthesout the puftules prematurely. This has num-
berlefs ill effects.  It not  only increafes the number of puftules, but
likewife tends to make them run into one  another; and when they
have been puflied out with too great violence, they generally fall is
before they come to  maturity.
  Women,  as foon as they fee the Small-pox begin to appear, com-
monly ply their tender charge with cordials, Saffron, and marigold-
tea -, v/ine, punch, and even brandy itfelf.  All thefe are given with
a view, as they term it, to throw out the  eruption from the heart.
Thjs, like moft other popular miftakes, is the abuSe of  a very juft
obfervation, that when there is a mot/lure on  thefkiny the pox rife better,
and the patient is eafiery than  when it continues dry and parched.  But
that is no reaSon  For Sorcing the patient  into a  Sweat.   Sweating
never relieves unleSs where it comes fpontaneoufly, or is the effect
of drinking weak diluting liquors.
  Children are often fo  peevifh,  that they will not lie a-bed with-
out a nurSe conftantly by them.  Indulging them in this, has many
bad effects both upon the nurSe and child. Even the natural heat of
the nurSe augments the  Sever of the child; but iS She, too, proves
feverifh, which is often  the cafe,  the danger muft be increafed*.
  Lying feveral children,  who have the fmall-pox, in the fame bed,
has many ill confequences. They ought,  if poffible, never to be in
the fame chamber, as the perfpiration,  the heat, the fmell, &c. all
tend to augument the fever, and to heighten the difeafe. It is com-
mon among the poor, to fee two or three children lying in the fame
bed, with fuch a  load of  puftules, that even their fkins flick  to-
gether.  One can  hardly view a fcene of  this kind, without being
Sickened by the fight. But how muft the effluvia affect the poor
patients, many of whom perifhed by this ufagef ?

  •3f I have known a nurfe, who had the fmall-pox before, fo  infedted
by lying conftantly  a-bed with a child, in  a bad kind of fmall-pox, that
fhe had not only a great number of puftules, which broke out all over her
body, but afterwards a malignant fever, which terminated in a number of
impofthumes or boils, and from which (lie narrowly efcaped with her life.
We mention this,  to put others upon their guard againft the danger of
this virulent infeftiorr.
  f  This obfervation is likewife applicable to hofpitalsj work-houfes,
&c.  where numbers of children happen to  have the fmall-pox at  the
fame tjme. I  have feen abo\ e forty children cooped up in one apartment, 
tyo             OF THE SMALL-POX:

 . A very dirty cuftom prevails among the lower claSs of people, of   <
allowing children in the Small-pox to keep on the Same linen dur-
ing the whole period of that loathfome difeafe.  This is done^left
they"fhould catch cold ;  but it has many ill confequences.  The
•linen becomes hard by the moifture which it abSorbs, and Sretsthe
tender fkin. It occafions a bad fmell, which is very pernicious both
to the patient and thofe about him ; befides, the filth  andfordes,
which adhere to the linen, being reforbed, or taken up again into
the body, greatly augment the difeafe.
  A patient fliould  not be fuffered  to be dirty in an internal difeaSe,
far  lefs in the fmall-pox. Cutaneous jdiforders are often occafioned
by naftinefs alone, and are always increafed by it.  Were the pa-
tient's linen to be changed every day, it would greatly  reSrefhhim.
Care, indeed, is to be taken, that the linen be thoroughly dry.  It
ought likcwiSe to be put on when the patient is moft cool.
  So Strong is the vulgar prejudice in this country, notwithftanding
all that has been Said againft the hot  regimen in the fmall-pox^ that
numbers ftill Sail a  Sacrifice  to that error.  I have Seen poor women
travelling in the depth of winter, gnd carrying their children alo'ng
with them in the fmall-pox, and  have frequently obferved others
begging by the way-fide, with infants in their arms covered with
the puftules; yet I could never learn that  one  of thefe children
died by this fort of treatment.  This is certainly a Sufficient proof
of  the fafety, at leaft, of expofing patients in the fmall-pox to the
open air.   There can be  no reafon, however, for expofing them to
public view. It is now very common in the environs of great towns
to meet patients in the fmall-pox on the public walks. This pactic*
may fuit the purpofes of boafting  inoculators, but is dangerous to
the citizens, and contrary to the laws of humanity and found policy.
   The food in this difeafe ought to  be very light, and  of a cooling  j
nature, as panado, or bread boiled with equal quantities of milk and \
water, good apples roafted or boiled with milk and fweetened with
a little fugar, or fuch-tike.  The drink may be equal parts of milk  '
and water, clear fweet whey, barley-water,' or thin gruel, &c.  Af-
ter the pox are full, butter-milk, being of an opening and cleanfing
nature, is a very proper drink.
   MEDICINE.-----This difeafe is generally divided into four dif-
ferent periods, viz.  the fever which precedes the eruption, the erup-
tion itfelf, the fuppuration,  or maturation of the puftules, and  the
Secondary fever.
   Little more is neceffary, during, the primary fever, than to keep

all  the while they had this difeafe, without any of them being admitted
to breathe the frefh air. No one can be at a lofs to fee the impropriety
of fuch conduct. It ought to be a rule, not only in hofpitals  for the fmall-
pc;x,  but,  likewife, for other difeafes,  that no patient fliould  be within
iij:ht or htan;i3 of another.  This is  a matter to which too little regard  •
is paid.   In moft hofpitals and infirmaries, the fick. the clyin'w ind the
detd, are  often to be feen in the fame apartment,          °" ' 
OF  THE SMALL-TOX.
171
 the patient cool and quiet, allowing him'-to drink diluting liquors,
 and bathing his Seet Srequently in warm water.  Though this be
 generally the SaSeft courSe that can be taken with infants/yet adults
 of a ftrong conftitution and plethoric habit fometimes require bleed-
 ing.  When a full pulfe, a dry fkin, and other fymptoms of inflam-
 mation render this operation neceffary, it ought to be performed ;
 but, unlefs thefe fymptoms are  urgent, it is fafer to let it alone; if
 the body is bound, emollient clyfters may be thrown in.
   If there is a great naufea,or inclination to vomit, weak camomile-
 tea, or lukewarm water may be drank,in order to clean the ftomach.
 At the beginning of a fever? Nature generally attempts Jkdifeharge,
 either upwards or downwards, which, iS promoted  by-gerrole means,
 would tend greatly to abate the violence of the difeaSe.
   Though every method is to  be taken during the primary fever,
 by a cool regimen, &c. to prevent too great an eruption ; yet, after
 the puftules have made their appearance, our-bufinefs is to promote
 the fuppuration, by diluting drink, light food, and, if Nature feems
 to flag, by generous cordials.  When a low, creeping pulfe faintish-
 nefs, and great lofs of ftrength,  render cordials neceffary, we would
 recommend good  wine, whicli^may be made  into negus, with an
 equal quantity of water, and fliarpened with the juice of orange,
 the jelly of currants, or the like. Wine-whey, fharpened as above,
 is likewife a proper drink  in this cafe ;  great care, however, muft
 be taken not to overheat the patient by any of thefe things. This,
 inftead of promoting, would retard the eruption.
   The rifing of the  fmall-pox is often prevented by the violence of
 the fever.   In this cafe, the cool regimen is Strictly to be obferved.
 The patient's chamber muft  not only be  kept cool, but he ouHit
 frequently to be taken cut of bed, and to be lightly covered with
 dothes while in it.
   Exceffive reftleflheSs often prevents the rifing and filling of the
 fmall-pox. When this happens, gentle opiates are necefi'ary.  Thefe
 ought always to be adminiftered with a fparing hand.  To an in-"
 fant, a tea-fpoonfui of the fyrup of poppies may be given eveiv
 five or fix hours till it has the defired effect.  An adult v\ ill require
 a table-fpoonful to anfwer die fame purpofe.
   If the patient be troubled with a Strangury, or Suppreflion oS urine,
 which oSten happens in  the Small-pox, he fhould be Srequently
 taken out oS bed, and, iS he be able, fhould walk acroSs the room
 with his feet bare.  When he cannot do  this," he may be frequently
 fet on his knees in bed, and fliould endeavour to pafs his urine as
. oSten as he can.  When theSe do not Succeed, a tea-SpoonSul of the
 Sweet Spirits of  nitre may  be occafionalJy  mixed with his  drink.
 Nothing more certainly relieves the patient, or is more beneficial in
 the fmall-pox,than a plentiful difeharge  of urine.
   If the mouth be foul, and the tongue  dry and chopped, it ought
 to be frequently wafhed., and the  throat gargled  with water  and
 honey, fharpened with a  little vinegar or currant-jelly. 
172
OF  THE  SMALL-POX.
  During the rifing of the  fmall-pox, it frequently happens, that
the patient is eight or ten days without a flool. This not only tends
to heat and inflame the blood, but the fceces, by lodging fo long in
the body, become acrid, and even putrid. From whence bad confe-
quences muft unfue. It will, therefore, be proper, when the body is
bound, to throw in an emollient clyfter every fecond or third day,
through the  whole courfe of the difeafe. This^will greatly cool and
relieve the patient.
  When petechia;, or purple, black, or livid fpots  appear among
the fmall-pox, the bark muft immediately  be adminiftered in as
large dofes  as the patient's ftomach can bear. For a child, two
drachms of  the bark in powder  may  be mixed in three ounces of
common water, one  ounce of  fimple  cinnamon-water, and two
ounces of the fyrup of orange or lemon. This may be fliarpened
with the fpirits of vitriol, and  a table-fpoonful of it given every
hour. If it be given to an adult in the  fame form, he may take at
leaft three or four fpoonfuls every hour. This medicine ought not
to be trifled with, but muft be  adminiftered as frequently as the
ftomach can bear it; in which cafe, it will often produce very hap-
py effects. I have frequently feen the petechia? difappear,and fmall-
pox, which had a very threatening afpect, rife and fill with laucjable
matter, by the ufe of the bark and acids.
  The patient's drink ought, in this cafe,to be generous; as wine or
ftrongnegus acidulated with fpirits of vitriol, vinegar, the juice of
lemon, jelly of currants, or fuch-like. His food muft confift of ap-
pies roafted or  boiled, preferved cherries, plumbs, and other fruits
of an acid nature.
   The bark and  acids are not  only  neceffary when the petechia
appear, but  likewife in the lymphatic orcryftalline Smali-pox,where
the matter is thin, and not duly prepared. The Peruvian bark Seems
to poffefs a  Angular power of aflifting Nature in preparing good
matter;  consequently, it muft be beneficial both in this and ether
difeafes, where the crifis depends on a fuppuration.  I have often
obferved, where the fmall-pox were flat, and the matter contained
in them quite clear and tranfparent,  and where, at firft, they had
the appearance of running into one another, that the bark, acidu-
lated as above, changed the colour and confiftence of the matter,
and produced the moft happy effects.
   When the eruption fubfides  fuddenly, or when the fmall-pox
frihe in, before they have arrived at maturity, the danger is very
great. In this cafe, blifters muft be immediately applied to the wrifts
and ancles,  and the patient's fpirits fupported with cordials.
   Sometimes bleeding has a furprifing effect in raifing the puftules
after they have fubfided ;  but it requires fkill to know when this
is proper, or to what length the patient can bear it.   Sharp cata-
plafms,  however, may be  applied to the feet and hands, as they
tend to promote  the Swelling of thefe parts.
   The moft dangerous period of this difeafe, is what we call the 
                 OF THE SMALL-POX.            V£

fecondary fever. This generally comes on when the fmall-pox be-
gin to blacken, or turn on the face ; and moft of thoSe who die of
the Small-pox, are carried off by this Sever.
   Nature generally attempts, at the turn of the fmall-pox, to re-
lieve the patient by loofe ftools. Her endeavours, this way, are by
no means to be counteracted, but promoted, and the patient, at the
fame time, Supported by food and drink of a nourifliing and eordial
nature.
   If, at the approach of the fecondary fever, the pulSe be very
quick; hard and ftrong, the heat intenSe, and the breathing laboril
ous, with  other Symptoms of an inflammation of the breaft, the
patient muft immediately be bled.  The quantity of blood to be
let, muft be regulated by the patient's ftrength, age, and the ur-
gency of the  fymptoms.
    But, in the fecondary fever, if the patient be faintifli, the puf-
 tules become  fuddenly pale, and if there be great  coldnefs of the
 extremities, blifters mult be applied, and the patient muft be fup-
 ported with generous cordials.  Wine, and even fpirits, have fome-
 times been given, in fuch cafes, with amazing SucceSs.
    As the Secondary Sever is, in great meaSure, iS not wholly, owing
 to the abSorption oS the matter, it would feem highly confonant
 to reafon, that the puftules, as foon as they come  to  maturity,
 fhould be opened. This is  every day practifed in other phlegmons
 which tend to fuppuration ; and there feems to be no caufe why it
 fhould be lefs proper here.  On the  contrary, we have reafon to
 believe, that,  by this means, the fecondary fever might always be
 leflened, and often wholly prevented.
    The puftules  fliould be opened when they begin to turn of a
 yellow colour. Very little art is neceffary for this operation.  They
 may either be opened with a lancet cr a needle, and the matter
 abforbed by a little dry lint. As the puftules are generally firft ripe
 on the face,  it will be  proper to begin with opening  thefe, and
 the others in courfe as they become ripe.  The puftules generally
 fill again, a fecond or even a third rime ; for which caufe, the opera-
 tion mult be repeated, or rather continued as long as there is  any
 confiderable  appearance of matter in fhe puftules.
    This operation, rational as it is, has been neglected from a piece
 of miftaken tendernefs in  parents. They believe that it muft give
 great pain to the poor child; and, therefore, would rather fee it die
  than have it thus tortured. This notion is entirely without founda-
  tion. I have frequently opened the puftules, when the patient did
  not fee me, without his being in the leaft fenfible of h ;  but, fup-
  pofe it where attended with a  little pain, that is nothing is compari-
  son to the advantages which arife from it.
    Opening the  puftules not only prevents  the resorption of the
  matter into the blood, but likewife takes off the tenfion oS the fkin,
  and, by that means, greatly relieves the patient.  It likewiSe tends to
  prevent  the pitting, which is a matter oS  no Small  importance. 
174
OF  THE  SMALLPOX.
Acrid matter, by lodging long  in the puftules, cannot fail to eor-
rode the tender fkin ; by which, many a  handfome face becomes
fo deSormcd as hardly to bear a reSemblance to the human figure*.
   It is generally neceffary, after the fmall-pox are gone off, to purge
the patient. If, however, the bpdy has been open through the whole
courfe of the difeafe, or if butter-milk and'other things of an open-  ,
ing nature have been drank freely after the  height of the fmall-pox,
purging becomes lefs neceffary ; but it  ought  never wholly to be
neglected.
   For very young children, an infufion of fenna and prunes, witli
alittle rhubarb, may be fweetened with coarfe fugar, and given in
fmall quantities till  it operates.   Thofe who are farther advanced,
muft take medicines of a fharper  nature.  For example ; a child
of five  or fix years of  age may take eight or  ten grains of jalap
over night, and the fame quantity of jalap in powder next morning.
This may be wrought off with frefh broth or water-gruel, and may
be repeated three or four times, five or fix days intervening between
each doSe.  For children Surther advanced, and adults, the dofe
muft be increaSed in proportion to the age  and conftitutionf.
   When impofthumes  happen alter the Small-pox, which is not
feldom  the caSe,  they muft  be  brought to Suppuration as Soon as
poffible, by means of emollient poultices; and when they have been
opened, or have broke  of their own accord, the  patient muft be
purged.  The bark and a milk-diet will be ufeful in this cafe.
   When a cough, a difficulty of breathing,  or other fymptoms of
a confumption, fucceed  to the fmall-pox, the patient muft be Sent
to a place where the air is  good, and put upon a courSe of afles.'
milk, with fuch exercife as he can bear. For further directions in
this cafe, fee the article Confumptions.

                         —*tss2K>---

                       Of Inoculation.

   THOUGH no difeafe, after  it is formed, baffles the powers of
medicine more effectually than  the  fmall-pox, yet more may be
done before-hand, to render this  difeafe favourable, thaa any one we
know; as almoft all  the danger from it may be prevented by inocu-
lation. This Salutary invention  has been known  in Europe above

  #■  Though this operation can never do harm, yet it is only neceffary
when the patient has a great load of fmall-pox, or  when the  matter
which they contain is of fo thin and acrid  a nature, that there is reafon
to apprehend b^ confequences from its being too quickly reforbed, ot
taken up again into the mafs of circulating humours'.
  t I have of Jate been accuftomed, after the fmall-pox, to «ive one two,
three, four, or five grains of calomel, according to the ace of the pa-
tient, over night, and to work it off next morning \\ith'a fuitable  dofe
ci jalap.. 
                 OF  THE  SMALL-POX.              17$

half a century; but, like moft other ufeful difcoveries, it has till of
late made but flow progrefs.  To the honour of this country,  ino-
culation has met with a more favourable reception here, than among
any of our neighbours. It is ftill, however, far from being general,
which we have reafon to fear will be the cafe, as long as the prac-
tice continues in the hands of the faculty.
   No  difeovery can be of general utility, while the practice of it
is kept in the hands of a few. Had the inoculation of the fmall-
pox been introduced as a fafliion, and not as a medical difeovery, or
had it been  practifed by the fame kind of operators here, as it is in
thofe countries Srom whence we learned it,  it had long ago been
univerfal. The fears, jealoufies, prejudices,  and oppofite interefts
of the faculty, are, and ever will be, the moft effectual obltacle* to
the progrefs of any Salutary difeovery.  Hence,  inoculation never
became, in any meaSure, general, even in England, till taken up by
men not bred to phyfic. Thefe have not only rendered the practice
more extenfive, but more SaSe, and by  acting under leSs reftraint
than  regular  practitioners, have taught them that the patient'9
greateft danger aroSe, not Srom the want of care, but the exceSs of it.
   They know very little of  the matter, who impute  the  fuccefs
of modern  inoculators to any fuperior fkill,  either in preparing the
patient or communicating the difeafe. Some of them, indeed, from
a fordid defire of engroffing the whole practice to themfelves, pre-
tend to have extraordinary fecrets or noftrums for preparing perfons
for inoculation,  which  never fail  of fuccefs.  But this is only  a
pretence to blind the ignorant. Common fenfe and prudence alone
are fufficient both in the choice of the fubject and management of
the operation. Whoever is poffeffed of thefe, may perform this office
for hischildren,whenever he finds it convenient, if they be in a good
 ftate of health.
   This fentiment is not the refult of theory, but  of  obfervation.
Though few phyficians have had more opportunities of trying in-
oculation in all its different forms,  fo little appears to me  to de-
pend on  thofe, generally reckoned important  circumftances,  of
preparing the body, communicating the infection by this  or the
other method, &c. that, for  feveral  years paft,  I have perfuaded"
the parents or nurfes, to perform the whole themfelves, and  have
 found that  method followed with equal fuccefs, while  it  is free
from any inconveniences that attend the other.*

   * A critical fituation, too often to be met with, firft put me upon try-
 ing this method.  A gentleman who had loft all his children, except one
 foil, by the natural fmall-pox,  was determined to have h'un inoculated.
 He told me his intention, and defired I would perfnadethe mother and
 grandmother, &c. of its propriety.  But that was impoflible. They were
 not to be perfuaded ; and either could not get the better of their fears,
 or were determined againft conviction. It was always a point with me,
 not to perform the operation withonttheconfentof the parties concern.
 ed.  I therefore advifed the father, after giving his fou a dofe or two
 of rhubarb, togoto a patient who had the fmall-po>: of a good  kind, 
,76             OF  THE  SMALL-POX.

""The fmall-pox may be communicated in a great variety of ways,
with nearly the fame degree  of fafety and fuccefs.  In  Turkey,
from whence we learned the practice,  the  women communicate
the difeafe to children, by opening a bit of the fkin with a needle,
and putting into the wound a little matter taken from a ripe  pof-
tule.   On the coaft of Barbary, they pals a  thread wet with the
matter through the fkin, between die thumb and lore-finger;  and,
in fome of the ftates of Barbary, inoculation is performed by rub-
bing in the variolous matter between  the thumb and fore^finger, or
on other parts of  the body.   Rubbing the variolous matter upon
the fkin, has been long known in many parts of Afia and^urope,
as well as in Barbary,  and has  generally gone by the name oibup
ingjthe fmall-pox.
   The prefent method of  inoculating in Britain,5? is to make two
or three Slanting incifions in the arm, fo fuperficial as not to pierce
quite through the fkin, with a lancet wet with Srefh matter taken
from a ripe pultule ; 'afterwards, the wounds are cloSed up,  and
leSt without any dreffing.   Some  make  uSe  of a lancet  covered
with the dry matter ;  but this is lefs  certain,  and ought never to ,
be ufed unlefs where frefh matter cannot be  obtained : when this
is the cafe, the matter ought to be moiitened by holding  the lan-
cet for fome time in  the Steam of warm water.
   Indeed, if frefh matter  be applied long enough to the 'fkin,
there is no occafion for any wound at all.  Let a bit  of thread,
about half an inch long, wet with  the matter, be  applied to the
arm,  mid-way between the lhoulder and elbow, covered with a
piece of common flicking plaifter, and kept on for eight or ten
days.  This will  feldom fail to communicate  the  difeafe.  W«
mention this method, becaufe many people are afraid of a  wound;
and, doubtlefs, the more eafily the operation can be performed,  it
has the greater chance to  become  general.  Some  imagine, that
the difeharge from a wound  leffens the eruption ; but there  is no
great ftrefs to be  laid upon this notion ;  befides,  deep wounds of-
ten ulcerate, and become troublefome.
   We do not find that inoculation is confidered as a medical ope-
ration in thofe countries from whence we learned it.  In  Turkey,
it is performed by the women, and,  in  the  Eaft-Indies,  by the

to open two or three of the puftules, taking up the matter with a little
cotton, and, as foon as he came home, to take his fon apart, and giveh'u
arm a flight fcratch with a pin, afterwards to rub the nlace well with
the cotton, and take no farther notice of it.  All this he'pun&ually per-
formed j and,  at the ufual period, the fmall-pox made their appearance,
which were of an exceeding good kind,  and fo mild, as not to confine the
boy an hour to his  bed. None of the other relations knew but the difeafe
had come in the natural way, till the boy was well.
   * The method praftifed in America,  differs only in the number of in*
ciilons : we find, that the matter inferted by one, is generally fufficient
to produce the defired effect,  without the. tcouble  ajid inconvenience
•f three.  (I. C.) 
                 OF THE  SMALL-POX.             177

Srachmins. In this country, the cuftom is ftill  in its infancy ; we
make no doubt, but it will foon become fo familiar, that parent3
will think no more  of inoculating their children,  than at pre-
fent they do of  i  ing them a purge.
   No Set of men have it fo much in their power to render  the
practice of inoculation general,  as  the clergy;  the greateft  oppo-
sition  to it ftill arifing from fome Scruples of  con fcience, which
they alone can remove.  I would recommend it to them not only
to endeavour to remove the religious objection's which weak minds
may have fo this Salutary praftice,  but to enjoin it as a duty, and
to point out the danger of neglecting to make ufe  of a  mean
which Providence  has put in our power for faving the lives of our
offspring.   Surely, fuch parents as  wilfully neglect the means of
faving their children's lives, are as guilty as thofe who put them to
death.   I with this matter were duly weighed.  No one is more
ready to make allowance for kuman weaknefs and religious pre-
judices; yet 1 cannot help recommending it,  in the war me ft man-
ner, to parents, to confider how great an  injury  they do their
children, by neglecting to give them this  diSeafe  inVthe early pe-
riod of life.
   The numerous advantages arifing from the inoculation  of the
fmall-pox, have been pretty fully pointed out by the learned  Dr.
M'Kcnzie, in his Hiftory of Health.*  To thofe mentioned by

   ■3f " Many and great,''1 fays tYis humane author, •' are  the dangers
attending the natural infection, from all which the innoculationis quite
fecure.  The natural infection may invade weak or diftempered bodies,
by no means difpofed for its kindly reception.  It may attack them at
a feafon of the year either violently  hot or intenfely cold   It may'be
communicated-from a fort of fmall-pox impregnated with the utmoft
virulence.  If jxmy lav hold of people  unexpectedly, when  a dangerous
fort is imprudently  imported into a maritime place.  It may furprife us
foon after exceffes committed in luxury, intemperance, or lewdnefs.  It
may likewife feize on the innocent after  indifpenfible watching?,  hard
labour, or neceffary journies. Aid is it a trivial advantage, that all thefe
unhappy circumftances can be prevented by inoculation ?  By inocula-
 tion, numbers arefe.ved from deformity as well  as from death.  In the
 natural fmall-pox, how often are the fineft features, and the moft beau-
tiful complexions miferably disfigured ?  Whereas, inoculation rarely
 leaves any ugly marks or fears, even where the number of  puftules  on
 the face has been very confiderable, and  the fymptoms by no means-fa-
 vourable.  And many other grievous  complaints, -that are frequently
 fubfequent to the natural fort,  feldom follow the artificial. Does not
 inoculation alfo prevent  thofe  inexpreffible terrors, that perpetually
 harrafs perfons  who never had this difeafe, infomuch, that when the
 fmall-pox is epidemical, entire villages are depopulated, markets ruined,
 and the face of diftrefs fpread over the whole country ? From this ter-
 ror it arifes,  that juftice is frequently  poftponed, or difcouraged, at fef-
 fions, or affizes where the fmall-pox rages. Witneffes and juries dare not
 appear ; and by reafon of the neceffary abfence of fome gentlemen, our
 honourable and ufeful judges are not  attended with that reverence and
 fplendour due to their office and merit.  Does not inoculation, in like
 manner, prevent our brave failors from being feized with this diftemper
 on fliipboard,  where they muft quickly fpread the infection among fuch 
 1?8             OF THE  SMALL-POX.

 him7we fhall only add, that fuch as have not had the fmall-ppx In
 the early period of life, are not only rendered  unhappy, but like-
 wife,  in a great meafure, unfit for iuftaining many of the molt
 ufeful and important Stations.  Few  people would c'eoofe  even to
 hire a fervant who had not had the fmall-pox, far lefs to purchafe
 a flave who had the chance of d ing of this difeafe.  How could
 a phyfician or a furgeon, who never had the  fm-ill-pox himfelf,
 attend others under that malady ?   How deplorable is the Situa-
 tion of females, who arrive-at mature age without having had the
 fmall-pox ! A woman with-child feldom Survives this diieafe : and
 if an infant happen to be fefeed -with the fmall-pox  upon the mo,
 ther's breaft,  who has not had the difeafe herfelf, the fcene muft
 be  diftreffing !  If  fhe continue to fuckle trie child, it is at the
 peril of her own life ; and if fhe wean it, in all probability, it will
 perifh.   How often  is the affectionate mother forced to leave her
 houfe,  and abandon her children,  at the very time when her care
 is moft neceffary ? Yet fhould parental  affection get the better of
 her fears, the confequences would oiita prove fatal.  I have known
 the mother and her infant laid in the fame grave, both victims to
 this malady.   Let parent^ who run-away with their children,  to
 avoid the fmall-pox,  cr who refufe to inoculate them in  infancy,
 confider to what deplorable Situations  they may be reduced by
 this mistaken tendernefs !
   As the fmall-pox is now become an epidemical difeafe  ir. moft
 parts  of the known world, no other  choice remains, but to render
 the malady as mild as poffible.   This is  the only manner of extir-
 pation now left in our power; and though it may feem paradoxical,
 the artificial method of communicating  the difeafe, could it  be
 rendered  univerfal,  would amount  to nearly the Same thing  as
 rooting it out.  It is a matter oS Small confequence  whether a dif.
 eaSe be entirely extirpated, or rendered So mild as  neither to de-
 ftroy  life nor hurt the conftitution ; but that this may be done  by
 inoculation, does not now admit oS a doubt.   The  numbers who
 die under inoculation hardly deServe  to be named.   In the natural
 way,  one in four or  five generally  dies ; but by inoculation not
 one of a rhoufand.   Nay, Some can boaft of  having  inoculated
 ten rhoufand  without the lofs of a fingle patient.
  I have often wifhed to fee fome plan eftablifhed  for  rendering
 this falutary practice univerfal.   The difficulties are  many; y«
 the thing is by no means impracticable.  The  aim is great;  no
 Jefs than faving the lives of  one-fourth part of  mankind* What
                              /•
 of the crew who never had it before, and where they have fcarce any
■chance to efcape, being half ftifled,with the clofenefs of their  cabins,
 and but very indifferently nurfed ? Laftly, with regard to the foldiery,
 the  mHeries attending thefe poor creatures, when attacked by the finally
pox on a march, are inconceivable—without attendance, without lodg-
 ings, without  any accommodation f  fo that one of three  convnonij
perifhes." 
                 OF THE  SMALt-WX.             179

ought  not to be attempted in order to accomplish (o desirable an
end ?
   The firft Step towards rendering the practice univerfal, muft be
•to remove the religious prejudices againft it.  This can only be
done by the clergy.  They muft not only recommend it as a duty
to others,  but likewife practife it on their own children.  Example
will ever have more influence than precept.
   The next thing requifite is, to put it in the power of all.  Ferr
this purpofe, let the faculty inoculate the children of the poor gra-
iis.  It is hard that fo ufeful a part of mankind  Should,  by their1
poverty, be excluded Srom Such a  benefit.
   Should this Sail, it is Surely  in  the power oS any ftate to render
the  practice general, at leaft as far as their dominion extends.  We
do not mean that it ought to be enforced by a law.  The beft way
to promote it, would br~, to employ a fufficient number of operators
at the public expenfe,  to inoculate the children of the poor. This
would only be neceffary till the practice became general ; after-
wards, cuftom, the ftrongeft of all laws, would oblige every indi-
vidual to inoculate his children to prevent reflections.           v
   It may be objected to this Scheme, that the poor would refufe
 to. employ the  inoculators; this  difficulty is eafily removed.  A
fmall  premium to enable  mothers to attend  their children while
 under this difeafe, would be a  fufficient inducement; befides, the
fuccefs attending the operation would foon banifh all objections to
it. Even considerations of profit would induce the poor to embrace
 this plan.  They often bring up their children to  the age of ten or
 twelve, and when they come to be ufeful, they are fnatched away
 by this malady, to the  great lofs  of their parents,  and detriment
 of the public.
   The Britifh legiflature has, of late years, Shown great attention
 to the prefervation cf  infant  lives,  by fupporting  the foundling
 hofpital,  &c,  But if  one-tenth part of the funis laid cut in fup-
 porting that institution, h:«d been bellowed  towards promoting in-
 oculation  of the fmall-pox among  the poor, ilot. only  more ufeful
 lives had been faved,  but  the practice ere now rendered quite uni-
 verSal in this ifland.  It h xot to be imagined, what efleet exam-
 ple and  a little money v/iii have upon the  poor ;  yet, if left to
 themfelves, they would go on for-ever in the old way,  withouE
 thinking  of any improvement.  We only mean this as a hint to the
 humane  and public-fpirited :  Should fuch a feheme Le approved,
 a proper plan might eafily  be laid down Sor the execution oS it.
    But as public plans are very difficult to bring  about, and often,
 by  the Sclfifh  views  and  mifconduct  cf thefe intrufted with the
 execution oS them, Sail of anfwering the noble purpofes for which
 they were defigned ;  we  fhall point  out feme  other method by
 which the benefits of inoculation may be extended,to  the  poor.
 There is no doubt but inoculators will  daily become more nume-
 rous.  We wouM  therefore have  every pr.rifh in Britain t»  allow 
i8o            OF THE SMALL-POX-

o^fjf them a fmall annual falary for inoculating all the children.
of the parifh at a proper age.  This imight be done at a very tn-
fling expenfe, and it would enable every one  to enjoy the benefit
of this falutary invention.
  Two things chiefly operate to prevent the progrefs of mocula-
tion.   The one is a wifti to put the evil day as far off as poffible.
This is a principle in our nature ;  and as inoculation feems rather
to be  anticipating a.future evil,  mankind are averSe to it.  But this
objection is Sufficiently anfwered b'y the fuccels. Who in his fenfe*
would not prefer a leffer evil to-day,  to a greater to-morrow, pro-
vided they  were equally certain ?
 ' The other obftacle is the fear of refle&ions. This has very great-
weight with the bulk of mankind.   Should the child  die, they.
think the world would blame them. This they cannot bear.  Here
lies the difficulty ;  and till that be removed, inoculation will mtikc.
but fmall progrefs.  Nothing, however, can remsve  it but cuftom-.
Make the practice fafhionabJe, and all objections will foon vanifli.
It is fafhion alone that has led the multitude fince the beginning
the world,  and wit lead them to the end.   We muft,  therefore,,
call upon the more enlightened part  of mankind  to fet a pattern
to the reft.  Their example, though it may for fome time meet with.
oppofition, will at length prevail.
   I am avare of an objection to this practice from the expenfe
 with  which it may be attended :  this is eafily obviated.  We do not.
mean that  every parifh ought to employ a Sutton or a Diaifdale as
inoculators.  Thefe have by their fuccefs already recommended
themfelves to crowned heads, and are beyond the vulgar reaeh;
but have not others an equal chance  to fucceed ? They  certainly
have. Let  them make the Same trial,  and the difficulties will Soon
 yapifh. There is not aparifh, and hardly a village in Britain, defti-
 lute  of Some perSon who can ble:d. But this is a far more difficult
 operation,  and requires more fkill and dexteritv than  inoculation.
   The .perfons to whom we would chiefly recommend the perfor-
 mance oS  this operation are the clergy. Moft oS them know Some-
 thing of medicine. Almoft  all of them bleed,  and can order a purga
 which are  all the qualifications neceffary  for the practice of inocu-
 lation. The priefts among  the lefs enlightened  Indians cerform^
 this office; and why fhould a Christian teacher think himfelf aborr '
 it ? Surely,  the bodies of men, as well as their fouls,  merit a part
 of the pallor's care ; at leaft the greateft Teacher who everappea- '
 red among men feems to have thought fo.
   Should  all other methods fail, we  would  recommend it to pa-
 rents to perform the operation themfelves.  Let them take any me-
 thod of communicating the difeafe they pleafe ; provided the Sub-
 jects be healthy, and of a proper age, they will feldom fail to fuc* ,
 ceed to their wifh. I have  known many inftances of mothers per- ,
 forming the operation,  and never fo much  as heard of one bal
 confequence.   A planter, in one of the Welt-India iflands, is Said 
               &F  THE SMALL-POX.             t£*

to have inoculated, with his own hand, in one year, three hun-
dred of his flaves •, who, notwithftanding the warmth of the cli-
mate, and other unfavourable circumftances, all did well.  Common
mechanics have often, to my knowledge, performed the operation
with as good fuccefs as phyficians. We do not mean to difeourage
thofe who have it in their power, from employing people of fkill to
inecuhte  their children, and attend them while under the difeafe \
but only to fhow, that where fuch cannot  be  had, the  operation
ought not upon that account to be neglected.                  /
  Inftead of multiplying arguments to recommend this practice,  I
flialljuft beg leave to mention the method which  I took  with my
own fon, then an only child. After giving him two gentle purges,
I ordered the nurfe to take a bit of thread,  which had been pre-
\ioufiy wet with frefh matter from a pock, and to lay it  upon his
arm, covering it with a piece  of fticking-plaiftcr. this  remained
on fix or Seven days,  til; it  was rubbed off by accident.  At the
ufual time, the frhall-pox mad-j their appearance, and were Exceed-
ingly favourable.  Surely, this,  which.is all  that is  generally necef-
fary, may be done without any fkill in medicine.
  We have been the more full upon this fubject, bee a ufe the bene-
fits oS inoculation cannot be extended to Society by  any other means
than making the practice general. While it is confined to a few,  it
muft prove hurtful to the whole. By means of it, the contagion is
Spread, and is communicated to many who might otherwise never
have had the diSeaSe. Accordingly, it is found, that more die of the
fmall-pox now, than  before inoculation was introduced ;  and this
important difeovery, by which  alone more lives  might  be faved
than by all the endeavours of the faculty, is in a great meafure loft/
by its benefits not being extended to thewhole community.*
  The fpring and autumn have been uSually reckoned  the  moft
proper SeaSons Sor inoculation, on account of the weather being
then moft temperate ; but it ought to be confidered that thefe are
gpnerully-the  moft unhealthy feafons of the-whole  year. Undoubt-
edly, the  beft preparation for the difeafe is a previous good ftate o£
health. I have always obferved, that clrildren, in particular, are more;
fickly towards the end of fpring and autumn, than  at any other
time of the year.  On this account, as well  as  for the advantage of
cool air, 1 would propofe winter as the moft  proper feafon for in-
oculation  ; though, on every other consideration, the^pring would
feem to be preferable.
  The moft proper age  Sor inoculation is between three and five.
Many approve of inoculating on the breaft, and where no circum-
ftances forbid this practice,  I  have  no objection  to  it.  Children-,
however, are more liable to convulfions  U this  time than after-

  * By a well-laid plan for extending inoculation,  more lives might b«
faved at a fmall expence, than are at prefent preferved by all the hop
*«!s In England, which coft the public fuch an amazing fuin. 
jS2
OF  THE CHICKEN-POX.
 wards; befides, the anxiety of the  mother or  nurfe, fliould the
 child be in danger, would not fail to heighten it by fpoiling the milk,
    Children who have conftitutional  difeafes, muft neverthelefs be
 inoculated. It will often mend the habit of body ; but ought to be
 performed at a time when they are moft healthy. Accidental difeafes
 fliould always be  removed before inoculation.
    It is generally  thought  neceffary  to regulate  the diet for fome
 time before the  difeafe  be communicated.  In children, however,
 great alteration in diet is feldom neceffary, their fbod being com-
 monly of the moft fimple and wholefome kind, as milk, watcr-pap,
 weak broths, bread light-pudding, mild roots, and white meats.
    But children who have been accuftomed to a hotter diet, who
 are of grofs habit, ought to be put upon a fpare diet before they are
 inoculated.  Their food fhould be of a light cooling nature,  and
 their drink whey, butter-milk, and fuch-like.
    We recommend no other medical preparation but two or three
 mild purges, which ought to be fuited  to the age and  Strength of
 the patient.   The SucceSs oS inoculators does not depend on  the
 preparation of their patients, but on their management of them
 while under the difeafe. Their conflant care is to keep them cool,
 and their bodies gently  open, by which means  the fever  is kept
 low, and the eruption greatly leffened. The danger is feldom great
 when the puftules are few ; and their number is generally  in pro-
 portion to the fever which precedes and attends the eruption.—
 Hence, the chief fecret of inoculation confifts in  regulating  the
 ,cruptive fever, which generally may be kept  Sufficiently low by the
 methods mentioned above.
    The  regimen during  the diSeaSe is in all refpects the Same as
 under the natural  Small-pox. The patient muft be kept cool, his
 diet fliould be light, and his drink weak and diluting, Sec.  Should
 any bad Symptoms appear, which is Seldom the caSe, they mull be
z treated in the Same way as directed in the natural Small-pox. Purg-
 ing is not leSs neceffary aSter the Small-pox, by inoculation than in
 the natural way, and ought by no means to be neglected.
               C H  A  P  T  E  R   XXV.

                    Of the Chicken-Pcx.

rnpHIS diSeaSe is more incident to children tjian to grown peo-
 _|_  pie.  It never affects the patient  more than once in his life;
and then it appears fo trifling as feldom  to require the affiftance
of a phyfician. The chicken-pox is a contagious difeafe, and isge-
nerally caught by  coming within t,he  infected atmofphere of the
patient or from the clothes of thofe who have been vifiting the fick. 
                OF THE  MEASLES.                183

  SYMPTOMS____This difeafe comes ori with moderate fymp-
toms of fever, which generally on the fecond day  is followed by
an eruption of red pimples over the whole  body.  They are foon
filled with a thin whitifh fluid, which fometiiies affumes a yellow
colour, with a light inflamed bafe, but the fluid contained  in the
puftules has not the property of pus or matter. After the eruption
is on the fkin, the fever fubfides, and, in three or four days, the puf-
tules dry, become of q. brown colour, and Scale off.
   It is a matter of the mcft ferious importance, to diftinguifh this
difeafe from the fmall-pox, as fometimes the moft dangerous con-
fequences have enSuedSrom the miftake. Children have been feiz~
ed with the Small-pox and have died, when their parents thought
they had pnfl  through the difeaSe.
   This diSeaSe may be diflinguifhed from the fmall pox, firft,by the
eruptive fever being more moderate and of fhorter duration.  Se-
condly, by  the puftules generally containing matter of the colour
ox milk.  Thirdly, by the puftules filling quicker and continuing a
fhorter time on the fkin, at fartheft not more than four or five days,
beSore they become dry, oSa brown colour, and Scale off*.
   MEDICINE.-----The treatment  cf this difeaSe fhould  be, by
cooling regimen, Similar to that uSed in  the fmall-pox. This muft
be more particularly attended to, if the fymptoms of fever  fhould
be confiderable, which is rarely the caSe.   ASter they empty, and
become dry,the patient muft be pnrged with jalop and cream-tartar.


              CHAPTER  XXVI.

                      Of the Meafles.

     THE meafles appeared in Europe about the fame time with
       the fmall-pox, and have a great affinity to that difeafe. They
both  came  from the fame quarter of the world, are both  infec-
tious,  and feldom attack the fame perfon  more than once.  The
meafles are moft common in the fpring  SeaSon, and generally dif-
appear in fummer. The difeaSe itSelf, when properly managed, Sel-
dom proves Satal; but its confequences are oSten very troubleSomc.
   CAUSE.----This  difeafe,  like the -fmall-pox, proceeds from
infection, and is  more or lefs dangerous, according to the confti-
tution of the patient, the feafon of the year,  the climate, Sec.
   SYMPTOMS____The meafles, like other fevers, are preceded
by alternate fits  of heat and  cold, with ficknefs, and lofs of ap-
petite.  The  tongue is  white, but generally  moift.   There is  a
fhort cough, a heavinefs of the head and eyes, drowfinefs, and  a
running at the noSe. Sometimes, indeed, the  cough does not come
before the  eruption has appeared.  There is an inflammation and
heat in the  eyes, with a defiuxion of fharp rheum, and great acute-
»efs of fenfation ; fo that they cannot bear  the light without pain, 
?84              OF  THE MEASLES.
The eye-lids frequently fwell fo as to occafion blindnefe.  The'pa-
tient generally complains of his throat; and a vomiting or loofe-
nefs often precedes the eruption.  The  flools in children are com-
monly greenifh.;  thsy complain of an itching of the fkin, and arc
remarkably peeviSh. Bleeding at the nofe is common, both  before
and in the progrefs of  the difeaSe.
   About the fourth day, fmall Spots, refembling flea-bites, appear,
firft upon the  face, then upon the breaft, and aSterwards on the
extremities: thefe may  be distinguished Srom the Small-pox by their
Scarcely rifing  above the fkin.  The Sever, cough, and di acuity of
breathing,  inftead of  being removed by  the eruption as in the
fmall-pox, are rather increafed': but the vomiting generally ceafes.
   About the Sixth cr Seventh day Srom the time of Sickening, the mea-
fles bef;in to turn pale  on the-face, and aSterwards upon the  body;
fo that by the ninth day  they entirely diSappear. The fever, however,
end difficulty  of  breathing, often continue, efpecially if the pa-
tient has been kept  upon too hot a regimen. Petechias, or purple
Spots, .may likewife be occafioned by this error. A violent loofenefs
fometimes fiicceeds the meafles; in which caSe, the patient's JiSe is
in imminent danger.
   Such as die of the meafles generally expire about the ninth day
from the invafion, and are commonly carried off by a peripneumony,
cr inflammation of the  lungs. The moft favourable fymptoms are,
a moderate loofenefs, a moift fkin, and a plentiful difc ha re of urine.
   When the eruption  Suddenly falls in,  and the  patient is feized
with a delirium, he is in the  greateft danger. If the  meafles turn
too  foon of a  pale colour, it is an unfavourable fymptom, as are
alfo great weaknefs, vomiting, .reftleffnefs, and  difficulty of Swal-
lowing.  Purple or  black Spots appearing  among the meafles are
very unfavourable. When a continual cough, with hoarfenefs, fiic-
ceeds the  difeafe, there is leafon  to fufpett an approaching 'con-
fumption of the lungs.
   Our bufinefs in.this difeafe is to affift Nature, by proper cordials,
in throwing out  the eruption, if her efforts be too languid ; but
when they are too  violent, they muft be  ftrained by evacuations,
and cool diluting liquors, &c. We ought likewife to endeavoufto
sppeafe the  moft  urgent fymptoms, as the cough, reftleffnefs, aud
difficulty of breathing.
   REGIMLN.----The cool regimen is neceffary here as well as
in the fmall-pox.  The  food muft be light,  and the drink diluting.
Acids do not anfwer fo well in the meafles as in the fmall-pox, as
they tend to exafperate  the cough. Small beer, though a good drink
in the fmall-pox,  is here improper. The moft fuitable liquors are
decoctions of  liquorice with marfh-mallow roots and farfaparilla,
mSufions of hnfeed, or of the flowers of elder, balm-tea, clarified
whey, barley-water  and Such-like.  Thefe, if  the patient be coftive,
may be fweetened with honey;  or, if that fhould difegree with the
ftomachj a little manna may occafionally be  added to them 
OF  THE  MEASLES.               185
   MEDICINE..----The  meafles being an inflammatory dife* e,
without any critical difeharge of matter, as in the fmall-p'x,  bL« d-
ing is commonly neceffary,  efpecially when the fever runs high,
with  difficulty of breathing, and great  oppreffion of the breaft.
But if the difeafe be of a miid kind, bleeding may be omitted .
   Battling the feet  and  legs frequently in lukewarm water, both
tends to abate the violence of the fever, and to promote the eruption.
 1  The  patient is often greatly relieved by vomiting. When thore
is a tendency this way, it ought to be promoted by drinking luke-
warm water, or weak camomile-tea.
   When  the cough is very troublefome, with drynefs of the throat,
a/id difficulty of breathing, the patient may hold his head over the
iteam of warm water, and draw the  fleam into his lungs.
   He may likewife  lick  a little Spermaceti and Sugar candy poun-
ded together ; or take now-and-then, a Spoonful of the oil of Sweet
almonds,  with  fugar-candy diflolved in it.  Thefe will foften  the
throat,  and relieve the tickling cough.
   If, at the turn of the difeafe, the fever affumes new vigour, and
there appears great danger of fuffocation, the patient mult be bled
according to his ftrength,  and blifters applied, with a view to pre-
vent the load from being thrown on the lungs; where, if an inflam-
mation  Should fix kSelf, the patient's life  will be in imminent danger.
   In  cafe the meafles fuddenly difappear,  it will  be  neceffary to
purfue  the Same method recommended when the Small-pox recede.
The patient muft be Supported with wine and cordials. Blifters muft
be applied to the legs and arms, and the body rubbed all over with
warm flannels. Warm poultices may likewiSe be applied to the feet
and palms oS the hands.
   When  purple or black  Spots appear, the patient's drink  fhould
be fharpened with Spirits of vitriol; and,  iSthe Symptoms increaSe,
the bark muft be adminiftered in  the Same manner, as  directed in
the Small-pox f.
   Opiates are Sometimes neceffary, but fhould never be given except
in caSes oS extreme  reftleffneSs, a violent looSeneSs, or when  the
cough is very troubleSome.  For children, the Syrup of poppies is
fufficient.  A tea-fpoonful or two may be occasionally given,  ac-
cording to the patient's age,  or the violence of the fymptoms.
   After the meafles are gone off, the patient ought to  be purged.
This  may be conducted  in  the fame manner as  directed  in  the
fmall-pox.
   If a violent loofenefs fucceeds the meafles, it may be checked bv
taking for fome days a gentle dofe of rhubarb in the morning, and

   * I do no: know any difeafe wherein bleeding is more neceffary than.
in  the meafles,  efpecially when the fever runs high : in this cafe, 1 have
al tv-iys found it relieve the patient.
  + Wine Jiiould be al owed the patient, to co operate with the bark, in
fuppornng the vigour oi the fyltein. This fhould be thepract.ee in all cafes
when tiiere is a tendency, as itiacorairionly  called, to putrefaction. (I. C) 
186           OF  THE  SCARLET  FEVER.
an opiate over night; but iS theSe do not remove it, bleeding will
Seldom Sail to have that effect.
  Patients recovering after the meafles fhould be careful what they
eat  or drink.  Their" food for fome time ought to be light, and'in
fmall quantities, their drink diluting, and rather of an opening na-
ture, as butter-milk,  whey, and fuch-like.  They ought alfo to "be-
ware  of expofing themfelves too foon to the cold air, left a fuffoca-
ting catarrh, an afthma,  or a confumption of the lungs fhould enfue.
  Should a cough, with a difficulty of breathing, and other fymp-
toms  of a confumption, remain after the meafles,  fmall quantities
of blood  may be frequently let, at proper intervals, as the patient's
ftrength and conftitution will permit. He ought to drink affes-mill;,
to remove to a free  air, if in a large town, and to ride daily on
horfeback.  He muft keep clofe to a diet of milk and vegetables; and
if thefe do not fucceed,  let him remove to a warmer climate'.
                    Of the Scarlet Fever.

   THE  fearlet  fever is fo  called from the colour of the patient's
fkin, which appears as if tinged with red wine. It happens at any
feafon of the year, but is moft common towards the end of fum-
mer ; when it often feizes whole families.  Children and  young
perfons are moft fubject to it.
   It begins, like other fevers, with coldnefs and fhiverings, without
any violent ficknefs. Afterwards the fkin is covered with red fpots,
which are broader, more florid,  and lefs uniform than the meafles.
They continue two or  three days, and then difappear ; aSter which
the cuticle, or Scarfi-fkin, falls off.
   There is Seldom any occafion  Sor medicine in this difeaSe. The
patient ought however to keep within doors, to abftain from flefh,

    Attempts have been made to communicate the meafles, as well as
the fmall-pox, by inoculation ; and we make no doubt, but in time, the
practice may fucceed. Dr. Home of Kdirfburgh, fays, he communicated
the dileai'e by the blood. Others have tried this method, and have not
found it fucceed. Some  think the difeafe would be more certainly com-
municated, by rubbing the ikin of-i patient,  who has the meafles, with
cotton, and afterward* applying tlft.- cotton to a wound, as in the fmall-
pox ;  while others recommend a bit oi flan-ul which had  been applied
to the patient's ikin, all  t»e time.of the difeafe, to be afterwards laid
n ion the am or leg of the perfon  to * horn the infection is to.be com-
  nmcated. Tueie isko doubr. but this difeafe, as well ... the fmall-pox,
U t^r?rn mU"IJ     KKViriOUS *"'**'> t!,e «">ft prabable,  however
is en.eriro.u cotton rubbed upon  the ikin, as mentioned  above  or bv
the^15e1n7im,;t?hV-be.^ '^T' ™bich *™**™™*W*%
as hate been inoculated, had the d.leafe very mildly; we therefore wife
rheprachce were more general, as the meafles hav/of latebecoirle C 
             OF  THE  BILIOUS  FEVER.           107

Strong liquors, and cordials, and  to drink freely  of cool diluting
liquors. If the fever runs high, the body muft be kept gently open
by emollient clyfters,  or cream of  tartar  and nitre, one  or two
drachms of the former, with eight or fen grains of the latter, may
be taken two or three times a day.
  Children and young perfons are fometimes feized at the begin-
ning of this difeafe with a kind of ftupor and epileptic fits. In this
cafe, the feet and legs  fliould be bathed in warm  water*,  a  large
blifter applied to the neck, and a dofe of the fyrup  of poppies given
every night till the patient recovers.
  The fearlet fever is not always fo mild.   It is fometimes attended
with putrid or malignant fymptoms, in which cafe, it is always dan-
gerous.  In the malignant Scarlet Sever the patient is not only af-
fected with coldnefs and fhivering, but rith languor, fickneSs, and
great oppreffion ; to theSe Succeed exceffive heat, naufea and vomit-
ing,  with a forenefs of the throat;  the pulfe is extremely quick,
but  fmall and depreffed;  the  breathing  frequent and laborious;
the fkin  hot, but  not  quite dry ; the tongue moift, and covered
with a whitifh mucus ; the tonfih inflamed and ulcerated. When
the eruption appears, it brings no relieS; on the contrary, the Symp-
toms  generally grow worSe, and Srelh ones come on, as purging,
delirium, &c.
  When this  diSeaSe is miftaken Sor a fimple inflammation, and
treated with repeated bleedings, purging and cooling medicines, it
generally proves fatal.  The only medicines that can be depended
on in this cafe are cordials and antifeptics, as the bark, wine, fnake-
root, and the like.  The treatment muft be in general fimilar to
that of the  malignant ulcerous fore throatf.
                    Of the Bilious Fever.

   WHEN a continual, remitting, or intermitting fever is accom-
panied with a frequent or copious evacuation of bile, either by vomit
or flool, the fever is denominated bilious.  In Britain, the bilious
fever generally makes its appearance about the end of fummer, and
ceafes towards the  approach of winter. It is moft frequent and
fatal in warm countries, efpecially where  the foil is marfliy, and

  * If the pulfe be full a«d hard, blood mult be taken from the arm or
juguiar vein.  (I. C.)
  t In the year  17*4, during winter, a very bad fpecies of this fever
prevailed in Edinburgh. It raged chiefly among young people. The erup-
tion was generally accompanied with a criiinfey, and the inflammatory
fymptoms were fo blended with others of a'putrid nature,  as to render
the treatment of the difeafe very ditficult-  Many of the patients, towards
the decline of the fever, were  afflifted with large fwellmgs of the fub-
inaxillary glands, and not a few had a fuppuration in one or both ears. 
  i8S          OF  THE  ERYSIPELAS,
  »*»««—
  wntn great rains are fucceeded by fultry Veats. Perfons who work
  wi\h u  doors, lie in camps, or who are expofed to the night air,
  are mod liable to this kind of fever.
    It there are fymptoms of inflammation at the beginning of this
  fevtr, it  will be necelfary to bleed, and to put the patient upon the
  cool u luting regimen recommended in the inflammatory fever.
  The faline  draught may be frequently administered, and  the pa-
  tient's body kept open by clyfters or mild purgatives. But if the
 fever fhould remit or intermit, bleeding will feldom be neceffary.
 In this caSe, a vomit may be adminiftered, and, if the body be bound,
 agentle purge; after which the bark will generally complete the cure.
   .In cafe of a violent loofenefs, the patient muft be fupported with
 chicken broth, jellies  of hartfhorn, and the like ; and he may ufe
 the white decoction for his ordinary drink*. If a bloody flux Should
 accompany this fever, it xnuft be treated as recommended  under
 the article Dyfentery.       '
   When  there is a burning heat, and the patient does not fweat,
 that evacuation  may be promoted  by giving him, three  or four
 times a day, a table-fpoonSul of Mindererus's fpiritf mixed in a cup
 oS his ordinary drink.
   If the bilious Sever be attended with the nervous, malignant, or
 putrid Symptoms, which is Sometimes the caSe, the patient muft be
 treated in the Same  manner as directed under thefe difeafes.
   After this fever,  proper care is neceffary to prevent a relapfe.
 For this purpofe, the patient, eSpecially towards the end of autumn,
ought to  continue the ufe of the bark for Some-time after  he is
well.  He fliould abftain from all trafhy fruits, new liquors, and every
kind of flatulent aliment.                                     '
               CHAPTER   XXVII.
                   y /h^-rt^^i^A. A<zcJ o-c^ri rukK
                   ?ryJpe!as/or St. Antbom's Fire.        <s

      HIS difeafe, which in fome parts of Britain is called the rofe,
       attacks perfons at any period of life, but is moft common
between the age of thirty and forty.  Perfons of a Sanguine or ple-
thoric habit,  are moft liable to it.   It often attacks young  people,
and pregnant women ;  and fuch as have once been  afflicted with
it, are very liable to have it again.  Sometimes it is a primary dif-
eafe,  and at  other tmies only a fymptom of fome other malady.
kVSPf"     ? br  Y 1S uab!6 t0 be attacked by an eryfipelas, bit
U moft frequently Seizes the legs or face, efpecially the latter. It is

Told and wT W aUtUmn, °r WhCn h0t WCather  is fuccceded  by
* See Appendix, White Decoftion.
See Appendix, Spirit of Mindererus. 
              OR  ST. ANTHONY'S  FIRE.           189

      CAUSES.-----The eryfipelas may be occafioned by violent paf-
   fions or affections of the mind; as fear,  anger, &c.  When  the
   body has been heated to a great degree, and is immediately expofed
   to the  cold air, fo that the perfpiration is fuddenly checked, an ery-
   fipelas will often enfue *.  Ic may alfo be occafioned by  drinking
   to excef6, by continuing  too long in a warm bath, or by any thing
   that overheats the blood. IS any oS the natural evacuations  be  ob-
^^tructed, or in too Small  quantity, it may cauSe an eryfipelas.  The
•a fame effect w ill Sollow from the ftoppage of artificial evacuations; as
\^ iflues,  fetons, or the  like.
^    SYMPTOMS.----The eryfipelas attacks with fhivering, thirft,
"*» loSs of ftrength, pain  in the head and back,  heat, reftleffnefs, a quick
■^j pulfe,  vomiting, and fometimes a delirium.  On the fecond, third,
 ^ or fourth day, the part Swells, becomes red, and Small puftules ap-         ^
J pear;  at which time the fever generally abates.                 Pj/Jjlfait1
 ^    When the eryfipelas Seizes the  foot, the parts contiguous ^ve^]»/'j/ y1  ,
   the fkin fhines ;  and, if the pain be violent, it wjll  afcend to fijfjjf/l^t't
   leg, and will not bear to be touched. /yfyn< owM U  J^^JiA^iA^} *   ™
      When it attacks the face, it Swells, appears red, and the fkin is
   covered with fmall puftules filled with clear water.  One, or both
   eyes are generally clofed with the Swelling; and there is a difficulty
   of breathing. If the  mouth and noftrils be very dry, and the pa-
   tient drowfy, there is reafon to fufpect an inflammation of the brain.
      If the eryfipelas affects the breaft, it Swells and becomes exceed-
   ingly hard, with great pain, and is apt to Suppurate. There is a vio-
   lent pain in the arm-pit, on the fide affected, where an abfeefs is of-
   ten formed.
      If in a day or two, the  fwelling fubfides, the heat and pain abate,
   the colour of the  part turns yellow, and the cuticle breaks and falls
   off in Scales, the danger is over.
      When the eryfipelas, is large, deep, and affects a very fenfible
   part of the body, the danger is great.  If the red colour changes
   into a livid or black, it will  end in a mortification. Sometimes the
   inflammation cannot be difcuffed, but comes to a fuppuration;  in
   which  cafe, fiflulas, gangrene, or mortification,  often enfue.
      Such as die of this difeafe, are commonly carried off by the fever,
   which  is attended with difficulty of breathing, and fometimes with
   a delirium and greac drowfinefs. They generally die about  the Se-
   venth or eighth day.
      REGIMEN.----In the eryfipehs the  patient muft neither be
   kept too hot nor too  cold, as either of thefe extremes will tend t»

     * The country people in many parts of Britain call this cl'.feafe a blaft,
   and imagine it proceeds from foul air, or ill wind, as they term it.  The
   trmh is, they  often lie down to reft them, when warm and  fatigued,
   upon the damp ground, where they fall afleep, and lie fo long as to catch
   sold, which occafions  the  erfiypelas. This difeafe may indeed proceed
   from other caufes,  but nine times  out of ten it is occafioned by ««ld,
   caught  after the body has b«en greatly heated or fatigued. 
190
OF  THE  ERYSIPELAS,
make it retreat, which is always to be guarded-againft. When the
difeafe is mild, it will be fufTicient to keep the patient within doors,
without confining  him to his bed, and to promote the perfpiration
by diluting liquors, Sec.
 ' The diet ought  to be flender. and of a moderately cooling and
moiftening quality, as groat-gruel, panado, chicken or barley-broth,
with cooling herbs and fruits, &c. avoiding flefh, fifh, ftrong drink,
fpices, pickles, and all other things that may heat and inflame the
blood ; the drink may be barley-water, an infufion oS elder-flowery
common whey, and Such like.
  But iS the pulSe  be low, and  the Spirits Sunk, the patient muft
be Supported with  ner^us, and other things of a cordial nature. His
food maybe fago gruel, with a little wine, and  nourifliing broths,
taken in fmall quantities, and often  repeated. Great careNmuft be
taken not to overheat him.
  MEDICINE----In this difeafe much mifchief is often done by
medicine, efpecially by  external applications. People, when they
fee  an inflammation, immediately think that fomething ought to
be applied to it.  i his indeed is neceffary in large phlegmons -, but
in an eryfipelas, the Safer courfe is to apply nothing.   Almoft all
ointments,  Salves,  and plafters, being  of a greafy nature, tend ra-
ther to obstruct and repel, than promote and difeharge Srom the
part.  At the beginning of this difeafe,  it is neither fafe to promote
a fuppuration, nor  to repel the matter  too quickly.  The eryfipelas
in many refpects reSembles the gout, and is to be treated with the
greateft caution. Fine wool, or very SoSt flannel, are the Safeftap*
plications to the part. TheSe not only deSend it Srom the external
air, but likewife  promote the perfpiration, which has a  great ten-
dency to carry off  the diSeaSe.  In Scotland, the common people
generally applv a mealv cloth to the parts^affected, which is not
improper.   /Ho** ^?W*  hart th*     Cy' C* lo^T
  It is commoner/ bleed in the eryfipelas ; but this requires cau-
tion.  If the fever be high, the pulSe hard and ftrong, and the'pa-
tient vigorous, it will be  proper to bleed ; but the quantity muft be
regulated by  theSe circumftances, and the operation  repeated as
the Symptoms may  require. IS the patient has been accuftomed to
ftrong liquors, and the  diSeafe attacks his head, bleeding is abfo-
lutely necelfary.
  Bathing the Seet and legs Srequently in lukewarm  water,  when
the  difeafe attacks the  face or brain,  has an excellent effect.  It
tends to make  a derivation from the head, and  feldt-m SailstQje-
Jieve the patient.   When bathing proves  ineffectual, poultiaff/ir
Slurp fynapiSms, may be applied to  the Soles oS the Seet,  for the
fame  purpofe.
  In cafes where  bleeding is requifite,  it is likewife.  neceffary to
keep the body open. This may be effected by  emollient clyfters,
or fmall dofes of nitre and cream of tartar. Some recommend very
large dofes of nitre in the eryfipelas ; but nitre  Seldom Sits eaSy oh 
OR ST.  ANTHONY'S  FIRE.
191
the ftomach, when taken in large dofes. It is one of the beft me-
dicines when  the fever and inflammation run high.  Haifa drachm
of it, wi*h one or two drachms of cream of tartar, may be given in
the patients ordinary drink, four times a day.
   When the eryfipelas leaves the extremities, and feizes the head,
fo as to occafion a delirium or ftupor, it is abfolutely neceffiiry tr>
open the body. If clyfters and miVt purgatives fail to have this ef-
fect, Stronger ones muft be given.  Blifters muft likewife be applied
to the neck, or behind the ears, and  fharp cataplafms laid to  the
Soles oS the feet.
   When the  inflammation cannot be difcufled, and the part has  a
tendency to ulcerate, it will then be proper  to promote fuppura-
tion, which may be done by the application of emollient poultices,
fuch as bread and milk, or thofe made with flaxfeed flower.
   When the  black, livid, or blue colour of the part fhows a ten-
dency to mortification, the bark muft be adminiftered. It may be
taken along with acids, as recommended in the fmall pox, or in any
other form, more agreeable to the patient.  It muft not however be
trifled with, as the patient's life is at flake. A  drachm may be given
e*ery two hours, if the fymptoms be threatening, and cloths dipped
in warm camphorated fpirits of wine, of the tincture of myrrh  and
aloes, may be applied to the part, and frequently renewed. It may
likewife be proper in this cafe to  apply poultices of the bark, or to
foment the part affected with a ftrong decoction of it.
   In what is  commonly called the fcorbutie eryfipelas^ which con-
forinues  at confiderable time, it will only  be neceffary to  give
gentle laxatives, and fuch things as promote the perfpiration. Thus,
after the inflammation has been checked by opening medicines, the.
decoction  of woods4 may be drank, after which a courfe  of bitters
will be proper.
   Such as are liable to frequent  attacks of the eryfipelas, ought
carefully to guard againft all violent paffions; to abftain from ftrong
liquors, and ail fat, vifeid, and highly nourifhing food. They fhould
likewife take fufficient exercife, carefully avoiding the extremes of
heat or cold.  Their food fhould confifl chiefly of milk, and-fuch
fruits, herbs and roots, as are of a cooiing quality ; and their drink
eught to  be fmall-beer, whey, butter-milk, and fuch like.  They
fhould never fuffer  themfelves to be  long coftive.* If that cannot
be prevented by fuitable diet, it will be proper to take frequently a.
gentle dofe of cream of tartar, the lenitive electuary, or fome other
mild  purgative.
# See Appendix, DecoSion of Wood*. 
[   '92   ]
              CHAPTER   XXVIII.

      OfthePhren\tis ; or, Inflammation of the Brain,
                  s
     THIS is fometimes a primary difeafe. but oftener only a fymp-
      tom of fome other malady ;  as  the inflammatory, eruptive,
or fpotted fever,  &c. It is very common, as a primary difeafe, in
warm climates, and is moft incident to perfons about the prime or
vigour of life.  The paffionate, the ftudious, and thoSe whofe ner-
vous Svftem is irritable in a high degree, are moft liable to it.
  CAUSES_____This difeaSe is often occafioned by night-watch-
ing,  efpecially when joined with hard ftudy : it may likewife pro-
ceed from hard drinking,  anger, grief or anxiety. It is often occa-
fioned by the ftoppage of ufual evacuations  ; as the  bleeding  piles
in men,  the cuftomary difcharges of women, &c Such as impru-
dently expofe themfelves to the heat of the fun, efpecially by fleep-
ing without doors in a hot feafon with their heads uncovered, are  1
often fuddenly feized with an inflammation of  the brain, fo as to
awake quite delirious  When repe Hants  are imprudently ufed in
an eryfipelas, an inflammation oS the brain  is Sometimes the  con-
Sequence.  It may be occafioned by external injuries, as blows or
bruifes upon the head, &c.
  SYMPTOMS.----The fymptoms  which ufually precede a true
inflammation of  the  brain are pain oS the  head. i^dneSs  of the
eyes, a violent fluftiing of the face, disturbed fleep, or a total want
of it, great drynefs of the fkin,  coftivenefs, a retention of urint,
a fmall dropping of blood from the nofe, finging of the  ears, and
extreme fenfibility of the nervous fyftem.
   When the inflammation is formed,  the fymptoms in general
are Similar to thoSe of the inflammatory fever. The pulSe indeed is
often weak, irregular, and trembling ;  but fometimes  hard and
contracted.  When the brain itfelf is inflamed, the pulfe is always
foft and low ; but when the  inflammation  only aff  cts the integu-
ments of the brain,  viz. the dura  and pia mater, it is hard.  A re-
markable quicknefs of hearing is a common f, mptom of this dif-
eafe ; but that feldom continues long.   Another ufual fymptom is
a great throbbing or pulfation in the arteries of the neck and tem-
ples.  Though the tongue is  often black and dry,  yet the patient
feldom complains of thirft,  and even  refufes drink,    l he  mind  ,
chiefly runs  upon fuch objects as have before made a deep impref-  ';
fion  on it;  and  fometimes,  from a fullen  filence, the patient be*
comes all of a fudden quite outrageous.
   A conftant trembling and Starting of the tendons is an unfavour-
able Symptom, as are alfo a  fuppreffion  of urine; a total want of
fleep ; a conftant Spitting ; a  grinding of the teeth, which laft may
be confidered as a kind of conyulfion.   When a phrenitis fucceeil 
               OF THE PHRENITIS,  &c.           ^93

 an inflammation oSthe lungs, of the inteftines, or of the throat, &c.
 it is owing to a translation of  the difeafe from  diefe parts to the
 brain, and generally proves fatal. This fhews the neceffity of pro-
 per evacuations, and the danger of repellents in all inflammatory
 difeafes.
   The favourable fymptoms are, a free perfpiration, a copious dif-
 eharge of blood from the nofe, the bleeding piles, a plentiful dis-
 charge of urine, which lets fall a copious fediment. Sometimes the
 difeafe is carried off by a loofenefs,»and in women by an exceffive
 .flow of the menfes.
   As this difeafe often  proves fatal in  a few days, it requires the
 moft Speedy applications. When prolonged, or improperly treated,
 it fometimes ends in madnefs, or a kind of ftupidity, which conti-
 nues for life.
   In the cure, two things are chiefly to be attended to, viz. to
 ieffen  the quantity of blood in  the brain, and to retard the circula-
 tion towards the head.
   REGIMEN.----The patient ought to be kept very quiet. Com -
 pany,  noife, and every thing that affects the fenfes, Or difturbs the
 imagination, increafes* the difeafe. Even too much light is hurtful:
 for which reafon,  the patient's chamber ought to be a little darken-
 ed, and he fhould  neither be kept too hot nor cold. It is not necef-
 fary to exclude the company of an agreeable friend, as this has a
 tendency to footh  and quiet the mind.  Neither ought the patient
 to be kept too much in  the dark, left it fhould oicafion a gloomy
 melancholy, which is too often the confequence of this difeafe.
   The patient muft, as far as poffible, he Soothed and humoured in
 every thing.  Contradiction will ruffle his mind, and increaSe his
 malady. Even  when he calls Sor things which  are not to  be ob-
 tained, or which  might prove hurtful, lie  is not to  be pofitively
 denied them, but  rather put off with the promiSe of having them
 as foon as they can be obtained, or by fome other excufe. A  little
 of any thing that  the mind is  fet upon, though  not quite proper,
 will hurt the patient lefs than a pofitive refufal.  Whatever  he
 was delighted with when in health, may here be tried; as pleafing
 Stories, SoSt mufic, or whatever has a tendency to Sooth the paffions
 and compofe the  mind.  Boerhaave propoSes feveral  mechanical
 experiments for this purpofe ; as the SoSt noiSe of water diftilling
 by drops into a bafon, and the patient trying to  reckon them, Sec-.
 Any uniform found, if low and continued, has a tendency to pro-
 cure fleep, and confequently may be of  fervice.
   The aliment ought to be light, confifting chiefly of farinaceous
 fubftances;  as  panado, and water-gruel, Sharpened with jelly of
 currants, or juice  of lemons, ripe fruit?., roafted or boiled, jellies,
 prefecves, Sec.  The drink, fmall, diluting, and cooling ;  as whey,   •»
 barley-water, or decoction of  barley and tamarinds, which latter
 not only render the liquor more palatable, but likewife more bene-
ficial, as they-are <Sf an  opening-nature. -  •
                             B 2 
194
OF  THE  OPHTHALMIA •,  OR,
   MEDICINE.----Nothing more  certainly relieves  the  patient
 than a free difeharge of blood from the nofe. When this comes of
 its own accord, it is by no means to be ftopped, but rather pro-
 moted, by applying cloths dipped in warm water to the part.
   Bleeding in the temporal arteries greatly relieves the head:  but
 as this operation cannot always  be performed, we recommend in
 its ftead, bleeding in the jugular veins.  When the patient's pulfe
 and fpirits are fo low, that he cannot bear bleeding with the lancet
 leeches may be applied to the temples-  TheSe not only draw off the
 blood more gradually, but by being applied  nearer to the part af-
 fected, generally give more immediate relief.
   A difeharge of blood from the hemorrhoidal veins is of great
 fervice, and ought by all means to be promoted.  If the patient has
 been Subject  to the bleeding  piles, and that difeharge has been
 ftopped, every method muft be tried to reftore it; as the applica-
 tion of leeches to the parts, fitting over the Steams of warm water,
 Sharp clyfters, or fuppofitories made of honey, aloes, and rock-Salt.
   IS the  inflammation of  the brain be occafioned by the ftoppage
 of. evacuations either natural or artificial, as the menfes, iffues,
 fetons, or fuch like, all means muft be uSed to reftore them as Soon
 as poffible, or to Subftitute others in their Stead.
  The patient's body muft be kept open by ftimulating clyfters or
 Smart purges  ; and Small quantities of nitre ought frequently to be
 mixed with his drink.  Two or three drachms, or more, if thecafu
 be dangerous, may be uSed in the Space of twenty-four hours.
  The head Should be fhaved and frequently rubbed  with vinegar
 and rofe-water. Cloths dipped in this mixture may likewife be  ap-
plied to the head *.  The feet ought frequently to be bathed in luke-
warm water,  and foft poultices  of bread and milk may be kept
 conftantly applied to them.
  If the difeafe proves obflinate, and does not yield to thefe medi-
 cines, it will  be neceffary to apply a blifter to the  whole head.
               CHAPTER   XXIX.

      Of the Ophthalmia ;  cr, Inflammation of the Eyes.

     THIS difeafe may be occafioned by external injuries ; as blows,
      burns, bruifes, and the like. It may likewife proceed Srom
dull, quick-lime, or other Subftances  getting into the eyes.  It is of-
ten catifed by the ftoppage oS cuftomary evacuations ; as the heal-
ing oS old Sores, drying up oS iffues, the Suppreffing of gentle morn-
m^ fwe .ts, or of the fweating of the feet, &c. Long expofure  to
the night air, especially in cold northerly winds, or whatever fud-

  * Even ice  when it can be procured, may ke employed with advaa-' 
INFLAMMATION OF THE  EYES;
clenly checks the perfpiration, efpecially after the body has been
much heated, is very apt to caufe it.  Viewing Show or other white
bodies for a long time, or looking ftedfaftly at the Sun, a clear fire,
or any bright object, will occafion this malady.  A Sudden tranfition
from darknefs to very bright light, will often have the fame effect.
   Nothing more certainly occafions an inflammation of the eyes
than night-watching, efpecially reading or writing by candle-light.
Drinking Spirituous liquors, an exceSs of venery, are very hurtful to
the eyes.  The acrid fumes of metals, and of feveral kinds of fuel,
are  alfo pernicious. Sometimes an inflammation of the eyes pro-
ceeds from a venereal taint, and often from a fcrophulous or gouty
habit. It may likewife be occafioned by the hairs in the eye-lids turn-
ing inwards, and hurting the eyes. Sometimes the difeafe is epide-
mic, efpecially after wet feafons ; and I have frequently known it
prove infectious, particularly to thofe who lived  in the fame houfe
with the  patient.  It may be occafioned by moift air, or living in
low damp hoafes, efpecially in perfons who are not accuftomed ta
fuch fituations. In children it often proceeds from imprudently dry-
ing  up of fcabbed heads, a running  behind the ears, or any other
difeharge of that kind.  Inflammations of the eyes often fucceed the
fmall-pox or meafles, efpecially in children of a fcrophulous habit.
   SYMPTOMS----An inflammation of the eyes is attended with
an acute pain, heat, rednefs, and Swelling. The patient is not abls
to bear the light, and fometimes he feels a pricking pain, as if his
eyes were pierced with a thorn. Sometimes he imagines his eyes are
full of motes, or thinks he fees flies  dancing before him.  The eves
are filled  with a fealding rheum, which rufhes Sorth in great quan-
tities, whenever the patient attempts to look up. The pulSe is ge-
nerally  quick and hard, with Some degree of fever. When the  dif-
eafe is violent, the neighbouring parts Swell, and there is a throbbing
or pulfation in the temporal arteries, &c.
   A flight inflammation of the  eyes, efpecially from an external
caufe, is  eafily cured; but when the difeafe  is violent,  and con-
tinues long, it often leaves fpecks upon the eyes, or dimnefs of fight,
and" fometimes total blindnefs.
   If the  patient be feized with a loofenefs, it has a  good effect j
and when the inflammation paffes  from  one eye to another, as it
were by infection, it is no unfavourable fymptom.  But when the
difeafe is accompanied v/ith a violent pain of the head, and  conti-
nues long, the patient is in danger of lofing his fight.
   REGIMEM.----The diet unlefs in fcrophulous caSes, can hard-
ly be too Spare, eSpecially at the  beginning. The patient mull ab-
stain from every thing of a heating nature. His food fhould confift
chiefly of mild vegetables, weak broths, and gruels.  His drink may
be barley-water,balm-tea,common whey, and fuch-like. His cham-
ber muft be darkened, or his eyes Shaded by a cover,fo as to exclude
the light, but  not to prefs upon the eyes.  He fhould  not look at a
eandle, the fire, or any luminous object; and ought to avoid all 
r96        OF THE  OPHTHALMIA;  OR,

Smoke, as the Sumes of tobacco, or-any thing that may caufe coughs
ing, fneezing, or vomiting. He fhould  be kept quiet, avoiding all
violent efforts, either of body or mind, and encouraging fleep as
much as poffible.
   MEDICINE.----This is one of thofe difeafes wherein great hurt
is often done by external applications.   Almoft every perfon pre-
tends to be poffeffed of a remedy for the cure of fore-eyes. Thefe
remedies generally confift of eye-waters and ointments, with other
external applications, which do miSchieS twenty times Sor once they
do good. People ought to be very cautious  how they ufe  Such
things, as even the preffure upon the eyes oSten increaSes the malady.
   Bleeding, in a violent inflammation of the eyes,  is always necef-
fary. This fhould be perSormed as near the part affected as poffible.
An adult may looSe ten or twelve ounces oS blood Srom the jugular
vein, and the operation may be repeated according to the urgency
oS the Symptoms. IS not convenient to bleed in the neck, the Same
quantity  may be let Srom the arm, or any other part oS the body.
   Leeches are oSten applied to the temples, or under the eyes, with
good effect*.  'I he wounds muft be Suffered to bleed for fome hours,
and if the bleeding flop foon, it may be promoted by the application
of cloths dipt in  warm water.  In obflinate cafes, it will  be necef-
fary to repeat this operation feveral times.
   Briflc purging with glauber fait, fhould be produced, during the
time bleeding is ufed; after that, the bowels may be kept open every
other day, with a decoction of tamarinds with Senna. A gentle dofe
of cream of tartar, caftor-oil, or any other laxative, will anfwer the
fame end.
   If the inflammation does not  yield to thefe evacuations, blifters
muft be  applied to the temples,  behind the ears, or upon the neck,
and kept open for fome time by the mild blifteriug  ointment. I
have feldom known thefe, if long enough kept open, fail to remove
the moft obflinate inflammation of the eyes; but for this purpofe,
it is often neceffary to continue  the difeharge  Sor Several weeks.
   When the difeaSe has been of long  Handing, I have  feen very
extraordinary effects from a feton  in  the neck,  or between the
Shoulders, efpecially  the  latter.  It fhould be  put upwards  and
downwards, or in the direction of the fpine, and  in the middle, be-
tween the Shoulder blades.  It may be dreffed tv-'ice a day with yel-
low  bafilicon. I have known patients,  who had been blind for.a
confiderable time, recover fight by means of a  Seton  placed as
above.  When the Seton is  put acroSs the neck,  it  Soon wears out,
and is both more painful and troublefome than between the fhoul-
ilers; befides, it  leaves a diSagreeable mark, andjdoes not difeharge
fo freely.                                   j
   When the  heat and pain oS the  eyes are vejry great, a poultice
of bread  and milk, Softened with fweet oil or  frefh butter, may be

  ■*  If leeches cannot be procured, blood may be qrawnfrom the teiu?
pie by cupping.   (I. C.) 
         INFLAMMATION  OF THE EYES.       197

 applied to them, at leaft all night;  and they may be bathed  with
 lukewarm milk  and water in the morning.
   If the patient cannot ilcep, which is fometimes the cafe, he may
 take twenty or thirty  drops of laudanum, or two fpoonfuls of the
 fyrup  of poppies, over night, more  or lefs according to his age, or
 the violence of the fymptoms.
   After the inflammation is gone off, if the eyes remain weak and
 tender, they may be  bathed every  night and morning with cold
 water and a little brandy, fix parts of the former to one of the lat-
 ter.  A method fhould be contrived  by which the eye can  be quite
 immerfed in the brandy and water, where  it fiiould be kept for
 fome time.  I  have generally found  this, or  cold water and vine-
 gar, as good a Strengthener  of the eyes as any of the moft celebra-
 ted  collyriums.
   When an inflammation oS the eyes proceeds  from a fchrophu-
 lous habit, it generally proves very obflinate.   In this cafe, the pa-
 tient's diet muft not be too  low,  and he may be allowed  to drink
 fmall  negus, or now-and-then a glafs of wine.  The molt proper
 medicine is the bark, which may be  given in fubftance, or prepared
 as follows :
   Take  an ounce of  the bark in powder, with  two drachms of
 Winter's bark,  and boil them in an  Englifh quart of  water to ;i
 pint;  when, it has boiled nearly lonvr enough, add half an  ounce ci
 liquorice root, fliced.  Let the liquerbe ftrained. Two, three, cr
 four  table-fpoonfuls, according to the age of the patient, may be
 taken  three or four times a-dap  It is iripoffible to Say how'lout1;
 this  medicine  fhould be continued, as the cure  is  Sooner performed
 in fome  than  in others ; but, in general, it requires a confiderable
 time to produce any lafting effects.
   Preparations  of mercury  may be  of  lingular  feivice in opthal-
 mias oS long continuance, but they  ought always to be adminifter-,
 ed with  the greateft caution, or by  perfons 01  fkill in phySie.
   It will be proper Srequently to look into the eye;;, to See iS any
 hairs be turned inwards, or preffing upon them'. Thefe  ou.pt to
 be plucked out with a pair oS Small  pincers.
   ThoSe  who are liable to frequent returns of this difeafe, ought
 conftantly to have an  iffue in one or both arms. Bleeding cr purg-
 ing in fpring  and autumn, will be very beneficial to Such perions.
 They ought likewife  to live with the greateft  regularity,  avoiding
 ftrong liquor,  and every thing of a heating quality.   Above al!, let
 them avoid the night air and late Itudiesf.

  *  Any foreign body lodged  in the eye may be expedltioufl/ '.-emovid
 by palling a fmall hair-pencil betu een t::e c/l-IUI ar.d the bali of the eye.
 In fome places, the peafants do ^'.j »-ery effectual:/, by uifeg ^'-;" toaguo
 in the fame manner.
  t  As molt people  arc f<rM\ of uiing  eye-waters and ointment!; in tin.,
 and other dife.fcs or' t::e vy<j-,  \vs have inflated  fome of the mo.: appro-
 ved forms of thcG.- ii:cc!':cii^i in th: -ipp'-j-.i'x. See Appendix, Eyc-w uur
aud I'-? falve. 
C   198  ]
               CHAPTER   XXX.

      Of the guinfey ; ory Inflammation of  the Throat,

     THIS diSeaSe is very common in Britain, and is frequently at-
      tended with great danger.  It  prevails  in the winter and
fpring, and is moft fatal to young people  of  a  Sanguine tempera-
ment.
  CAUSES_____In general it proceeds from the fame  caufe as
other inflammatory diforders, viz. an obftrudted  perfpiration.- It
is often occafioned  by omitting fome part of the covering, ufually
worn about the neck, by drinking  cold liquor  when the body is
warm, by riding or walking againft a cold northerly wind, or by
any thing that greatly cools the throat, and parts adjacent. It may
likewife proceed from the neglect of bleeding,  purging or any
cuftomary evacuation.
  Singing, fpeaking loud and long, or whatever Strains the throat,
may likewiSe cauSe an  inflammation of that  organ.  I have often
known the  quinSey prove fatal to jovial companions, who, after fit-
ting long in a warm room, drinking hot liquors,  and Singing with
vehemence, were fo imprudent as to go abroad in the cold night-
air.  Sitting with wet feet, or keeping on  wet clothes, is  very apt
to occafion this malady. It is Srequently occafioned by continuing
long in a moift place,  fitting near*m open window, fleeping in a
damp bed, fitting in a room that has been newly plaftered, &c. I
know people  who never fail to have a Soar throat, if they fit even
but a fhort time in a room lately wafhed.
  Acrid or irritating Sood may inflame the throat, and occafion a
quinSey.  It may proceed Srom bone?, pins, or other Sharp Subftan-
ces flicking in the throat, or Srom the cauftic  fumes of metals or
minerals, as arfenic, antimony, &c. taken in by the breath. This
difeafe is fometimes epidemic  and  infectious.
  SYMPTOMS.----The inflammation  of the  throat is evident
from infpedtion, the parts appearing red and  Swelled ; befides, the
patient complains of pain in Swallowing. His pulSe is quick and
hard, with other Symptoms oS a fever. If blood be let, it is gene-
rally  covered  with a tough coat of  a whitifh colour, and the pati-
ent fpits  a  tough phlegm.  As the Swelling  and  inflammation in-
creafe, the breathing  and fwallowing become more difficult; the
pain affedts the ears ; the eyes generally appear red ; and the face
Swells.  The patient  is often obliged to keep himfelf in an erect
pofture, being in danger of Suffocation; there is a conftant nauSea,
or inclination to vomit; and the drink, inftead  oS paffing into the
ftomach, is oSten returned by the noSe. The patient is Sometimes
itarved at laft,mereiy Srom an inability to Swallow any kind of Soocl.
  When the breathing h laborious, with StraitKeSs of the breaft, 
                 OF THE  QUINSEY.               X99

and anxiety, the danger is gTeat. Though the pain in Swallowing be
very great, yet while the patient breathes eafy, there is not fo much
danger. An external Swelling is no unfavourable Symptom; but if it
fuddenly falls, and the difeafe affects the breaft, the danger is very
great.   When a quinfey is the confequence of  fome other difeafe,
which has already weakened the patient, his fituation is dangerous.
A frothing at the mouth, with  a Swelled tongue, a pale,  ghaftly
countenance, and coldneSs of the extremities, are fatal fymptoms.
   REGIMEN.----rThe regimen in this difeafe is in  all refpects
the fame as  in the pleurify, or peripneumony.  The food muft be
light, and in fmall quantity, and the drink plentiful, weak and di-
luting, mixed with acids.
   It is highly neceffary that the patient be kept eafy and quiet.  Vi-
olent affections of the mind, or great efforts of the body, may prove
fatal.  He fhould not even attempt to fpeak but in a low voice.
Such a degree of warmth as to promote a conftant, gentle fweat,
is proper. When the patient is in bed, his head ought to be raif-
ed a little higher than ufual.
   It is peculiarly neceffary that the neck be kept warm ; for which
purpofe, feveral folds of foft flannel may be wrapt round  it.  That
alone will often remove a flight complaint of the throat, if appli-
ed in due  time.  A judicious cuftom  prevails among the peafants
of Scotland :  When  they feel any uneafinefs of the throat, they
wrap a flocking about it all night.  So effectual is this remedy, that
in many places it pafles for a charm, and  the flocking is applied
with  particular ceremonies: this cuftom fliould never be neglec-
ted.  When the throat has been thus wrapt up all night, it muft
not be expofed to the cold air through the day, but a handkerchief
or a pieceof flannel kept about it till the inflammation be  removed.
   The jelly cf black  currants is a medicine very much in efteem
for complaints of the throat;  and is of fome ufe.  It fhould be al-.
moft conftantly kept in the mouth, and fwallowed down  leifurely.
It may be mixed in the patient's drink,  or taken any other way.
When it cannot be obtained, the jelly of red currants, or cf mul-
berries, may be ufed in its ftead.
   Gargles for the throat are very beneficial. They may be made of
fage-tea, with a little vinegar and honey, or by adding to half an
Englifh pint of the pectoral decoction, two or three  fpoonfuls
of honey, and the fame quantity of currant jelly.  This may be
ufed three or Sour times a-day; and iS the patient be troubled with
tough  viScid phlegm, the gargle may be rendered more Sharp  and
cleanfing, by adding to it a tea-SpoonSul of the fpirit of fal ammo-
niac.  Some  recommend gargles made of a decoction of the leaves
or bark of the black-currant-bufh ; but  where jeliy  ca:i be had,
thefe are unneceffary.
   In no difeafe is the benefit ©f bathing the feet and legs in luke-
warm water more apparent :  that practice ought therefore never
to be neglected.  If people were careful to keep warm, to wrap up 
»oo          OF THE  QUINSEY ;  OR,

their" throats with flannel, to bathe their feet and legs in warm wa*
tcr, and to ufe a Spare diet, with diluting liquors, at the beginning
of this diSeaSe, it would Seldom proceed to a great height, or be at-
tended with any danger : but when theSe precautions are neglec-
ted,and it becomes violent, more powerful medicines are neceffary.
  MEDICINE____-An inflammation oS the throat  being a moft
acute and dangerous diftemper, which Sometimes takes off the pa-
tient very Suddenly, it will be proper, as Soon as the Symptoms ap-
pear, to bleed in the arm, or rather in the jugular vein, and tore-
peat the operation iS circumftances require.
  The body fhould be kept gently open by  giving the patient for
his ordinary drink, a decoction oS figs and tamarinds, or Small dofes
of cream of tartar  and nitre, as  recommended in the  eryfipdas.
Thefe may be increafed according to the age of the patient, and
repeated till they  have the defired effect.
  I have often known very good  effects from a bit of fal prunel,
or purified nitre,  held in the mouth,  and  fwallowed down as  it
melted.  This promotes the difeharge of faliva, anfwers the end of
a gargle, while at the fame time it abates the fever,  by promoting
the difeharge of urine, &c.
  The throat  ought to  be rubbed twice or thrice  a-day with a
little of the volatile liniment.   This feldom fails to  produce fome
good effects.  At  the fame time  the neck ought to be carefully
covered with wool or flannel, to prevent the cold  from penetrating
the flcin, as this application renders it very tender.   Many other
external applications  are recommended in this diSeaSe,  but there  '
is'none preSerable to a common poultice oS bread and milk.
  Some recommend the gum guaiaeum as a Specific in this dif-
difeaSe.  HalS a drachm oSthe gum in powder may be made into
an electuary with the rob oS elder-berries,  or the jelly of currants
for a dofe,  and repeated occafionally.
   Blifters upon the neck or behind the ears in violent inflamma-
tions oS the throat are very bem- 'rial ; and in bad caSes it will be
necefiary to lay a blifter quite acroU the throat, So as to reach from
ear to ^ar.  After the plafters  arc taken off, the parts ought to be
kept running by the application of Mine ointnieur,  till the inflam-
mation i-j gone ; othei wife, upon  their drying Up, the patient'will
be  in danger cf a relanf.?.
   When the patient iias been treated as above,  a Suppuration fel-
dom happens. T!  is, howcver,is Sometimes'the cafe, in Spite of all
endeavours to prevent it.  When the iiithimrmrfeui and Swelling
continue, and a .,.  evident that a Suppuration will enSue, it ought^
to  be  promoted by drawing the  fleam of warm water into  the
tl^-:c\r. through a.<nunc', or the  like.  SoSt poultices ought to be
upph 1 ou v/ardly, and  ■; 1.  patient  may  keep  a rem.:d°fig con-  !
ftai:' y in hij mouth.
   li Sometimes happens,  before the tumour breaks,  that the fwel-
livjjis So great, as entirely to prevent any thing from getting down- J 
      INFLAMMATION OF  THE THROAT.     20 r

into the ftomach. In this cafe, the patient muft inevitably perifh,
unlefs he can be fupported in fome other way. This can only be
done by nourifliing clyfters of broth, or gruel with milk, &c. Pa*
tients have often been fupported by thefe for feveral days, till the
tumour has broke ;  and afterwards they have recovered.
   Not only the fwallowing, but the breathing, is often prevented
by the tumour.  In this  cafe, nothing can fave the patient's life,
but opening the trachea, or windpipe. As that has been often done
with fuccefs,  no perfon,  in fuch defperate circumftances,  ought
to hefitate  a moment about the operation; but as  it can only be
performed  by a furgeon, it is not neceffary here to give any direc-
tions about it.
   When a difficulty of fwallowing is not  attended with an acute-
pain or inflammation, it  is generally owing  to an  obftruction of
the glands about the throat, and only requires that the part be
kept warm, and the throat frequently gargled with fomething that
may gently ftimulate the glands, as a decoction of  figs with vine-
gar and honey ; to  which may be  added a  little muftard,  or a
Small quantity of fpirits.  But this gargle is never to  be ufed where
there are figns of an inflammation.  This fpecies of angina has Va-
rious names among the common people, as the pap of the throatf
the falling down of  the almonds of the ears, &c. Accordingly, to
remove it, they lift the patient up by the hair  of the head, and
thruft their fingers under his jaws, &c. all which practices are at
beft ufelefs, and often hurtful.
   Thofe who are fubject  to inflammations of the throat, ih ordet
to avoid that difeafe, ought to live temperate. Such as do not choofe
to obferve this rule, muft have frequent recourfe to purging and
other evacuations, to difeharge the fuperfluous humours.  They
ought likewife to beware of catching cold, and fhould abftain from.
aliment and medicines of an aftringent or ftimulating nature.
   Violent  exercife, by increafing  the motion and force  of the
blood, is apt to occafion an inflammation of the throat, efpecially
if cold liquor be drank immediately after it, or the body Suffered
fuddenly to cool.  Thofe  who  would avoid this difeafe, ought,
therefore, after fpeaking aloud,  finging, running,  drinking warm
liquor, or doing any thing that may ftrain the throat, or increafe
the circulation of the blood towards it, to take care to cool gradu-
ally, and to wrap fome additional coverings about their necks.
   I have often known perfons, who had been fubject  to fore throats,
entirely freed from  that complaint by only wearing a ribband, or
a bit of flannel conftantly round their necks, or by  wearing thick-
er fhoes,  a  flannel waiftcoat, or the like. Thefe may feem trifling,
but they  have great effect. There is danger indeed in leaving them
off after perfons have been accuftomed to them ;  but furely the
inconveniency of ufing fuch things  for life,  is not  to be compar»
ed with the danger which may attend the neglect of thera^ 
*02  OF THE  MALIGNANT QUINSEY ; OR,

  Sometimes, after an inflammation,, the glands of the throat con-
tinue fwelfed, and become hard and callous. This  complaint i«
not eafily removed, and is often  rendered dangerous by the too
frequent application of ftrong flimulaiing and Styptic medicines.
The beft method is to keep it warm, and to gargle it twice a-day
with a decoction of figs, fharpened a little with the elixir or Spirit
oS vitriol.
Of the Malignant £uinfcy; Or, Putrid, Ulcerous Sore Thrtyt.

  THIS kind oS quinfey is but little known in the north oS Britain,
though, Sor Some time paft, it has been  fatal in the more Southern
counties :  It is Srequently  to be met with in America.  Children
are more liable to it than adults,  Semales than males, and the de-
licate than thoSe who are hardy and robuft.  It prevails chicly in
autumn, and is moft Srequent aSter a long courSe oS damp or Sultry
weather.
  CAUSES.----This is a contagious  diftemper, and  generally
communicated by infection.  Whele lamilies, and  even entire vil-
lages, oSten receive the infedtion Srom one  perfon. This ought to
put people on their guard  againft going near Such patients as la-
bour under the  diSorder;  as they endanger their  own lives, and
thoSe oS their friends and connexions. Whatever tends to produce
putrid or malignant fevers, may occafion the putrid  ulcerous fore
throat, as  unwholeSome air, damaged provisions, neglect of clean-
linefs, &c.
  SYMPTOMS.----It begins with alternate fits of fhivering and
heat.   The pulfe is quick,  but  low and unequal, and  generally
continues  fo through the whole courfe of the difeaSe.  The patient
complains greatly oS weakneSs and oppreffion of  the breaft; his
Spirits are  low, and he is apt to Saint away when Set upright; he is
troubled with a naufea, and oSten with a vomiting or  purging.
The two latter  are moft common in children.  The e^es appear
red and watery, and the face Swells. The urine is  at firft pale and
crude ; but, as the diSeaSe advances, it  turns more of a yellowifti
colour. The tongue is white, and generally moift, which diftin-
guifhes this from an inflammatory difeafe.  Upon looking into the
throat, it appears Swelled, and of a  florid red colour. Pale or afh-
coloured fpots, are here and there interfperfed, and fometimes one
feroad patch or fpot, of an  irregular figure,  and pale white colour,
furrounded with florid red, only  appears.  Thefe whitifh fpots or
Doughs cover fo many ulcers.
  An efrlorefecnce, or eruption upon the neck, arms, breaft, and
fingers, about the fecend or  third day,  is a common fymptom of
this difeafe.  When it appears, the purging and vomiting generally
ceafc.                                             ot>      i 
      PUTRID, ULCEROUS SORE THROAT.   *o$

   There is often a flight degree of delirium; the free frequently
Appears bloated,  and the infide of the noftrils red and ^«»med'
The patient complains of a difagreeable putrid fmell, and his breath
is very offenfive.                                         *
   The putrid, ulcerous fore throat may be diflinguifhed from the
inflammatory by the vomiting and loofenefs with which it is gene-
rally ufhercd in ; the Soul ulcers in the throat covered with a white
or livid coat ; and by the exceffive weakneSs of the patient; with
other Symptoms oSa  putrid fever.
   UnSavourable Symptom? are,  an obflinate purging, extreme
 weakneSs, dimneSs of the fight, a livid or black colour oS the Spots,
 and Srequent fhiverings, with a weak, fluttering pulfe. If the erup-
 tion upon  the fkin fuddenly difappears, or becomes of a livid co-
 lour, with a difeharge of blood from the nofe  or mouth, the dan-
 ger is very great.
   If a gentle fweat break out about the  tmid  or Sourth day, and
 continue with a flow, firm, and equal pulfe ; iS the floughs caft off
 in a kindly manner,  and  appear clean and florid at the bottom;
 and iS the breathing is SoSt and Sree,  with  a lively colour  of the
 eyes, there is reafon to hope for a Salutary ciifis.
    REGIMEN.----The patient muft be kept quiet, and for the
 moft part in bed, as he will be apt to  Saint when taken out of .it.
 His  food  muft be  nourifhing and reftorative ; as Sago-gruel with
 red wine, jellies, ftrong broths,  &c. His drink ought to be gene-
 rous, and oSan antifeptic quality ; as red wine negus, white wine
 whey, and Such like.                           ■    ,
    MEDICINE.----The medicine in this kind  of  quinSey is en-
  tirely different from that which is proper in the  inflammatory. All
  evacuations, as bleeding, purging, &c. which weaken the patient,
  muft be avoided. Cooling medicines, as nitre and cream of tartar,
  are  likewife hurtful. Strengthening  cordials alone can  be ufed
  with fafety ; and thefe ought never to be negfeaed.
    If at the beginning there is a  great naufea,  or inclination  to
  vomit, the patient muft drink an inSuSion cf  green tea, camomile
  flowers, ox carduus beneditlusy in order to  cleanfe the ftomach.  IS
  thefe are  not Sufficient, he may take a few  grains of the powde*  oi
  ipecacuanha, or any other gentle vomit.                • rr
    If the difeafe is mild, the throat may be  gargled with an infufion
  of fage and rofe leaves, to a gill of which may **? added a fpoonf ul
  or two of honey, and as much vinegar as will  make it agreeably
  acid ;  but when the fymptoms are urgent, the  floughs  large and
  thick, and the breath very offenfive, the following gargle may  be
   ufed:                                      .     ,    ,  ...
    To fix or feven ounces of the peaoral decoaion, when barfing,
   add half an ounce of contrayerva-root; let it boil  for fome time
   and afterwards ftrain the  liquor ;  to which add two ounces  of
   white wine vinegar, an ounce of fine honey, and an ounce of the 
2o4   OF THE MALIGNANT QUINSEY, &c.

tinaure of myrrh. This ought to be ufed as a gargle, and a little
of it ihould frequently be  injeaed, with a fyringe to clean the
throat, before the patient takes any meat or drink.  This method is
peculiarly neceffary for children, who cannot ufe a gargle.
   It will be of great benefit if the patient frequently receives into
his mouth, through an inverted funnel, or proper inhaler, the
fleams of warm vinegar, myrrh, and honey.
   But when the putrid fymptoms run high, and the difeafe is at-
tended with danger, the only medicine that can be depended up-
on is the Peruvian bark. It may be taken in fubftance,  iS the pa-
tient's ftomach will bear it.  IS not, an ounce of bark groSsly pow-
dered, with two drachms of Virginian fnake-root, may be boiled
in an  Englifh pint and a half of water, to half a pint; to which a
rea-fpoonful of the elixir of vitriol may be added, and an ordinary
tea-cupful of it taken every three or four hours. Blifters are  very
beneficial in this diSeaSe,  eSpecially when the patient's  pulSe and
fpirits are low. They may be applied to the throat,  behind the
ears, or upon the back part of the neck.
   Should the vomiting prove troublefome,  it will be  proper to
give the patient two table-fpoonfuls of  the faline julep every hour.
Tea made of  mint and a little cinnamon will  be very proper for
Ins ordinary drink, efpecially  if an equal quantity  of red wine be
mixed with it.
   In cafe of a violent loofenefs, the fize of a nutmeg of diafcordium
or fix or eight drops of laudanum, according to the age  of the pa-
tient, may be  taken in cinnamon water two or three times a-day;
the japonic confeaion  may be taken two or three  times a-day, or
oftener if neceffary.
   If a difeharge of blood from the nofe happens, the  Steams of
■warm vinegar may be received up the noftrils frequently ;  and
the drink muft be fharpened with fpirits of vitriol, or tincture of
jofes.
   In  cafe of a Strangury, the belly muft be fomented with warm
water, and emollient anodyne clyfters given three  or four times
a-day.
   After the violence of the difeafe is over,  the body fhould ftill
be kept open  with mild purgatives ; as manna, fenna, rhubarb, or
the like.
   If great weaknefs and dejeaion of fpirits, or night-fweats, with
other fymptoms of  a confumption, fhould enSue,  we advife the
patient to continue the uSe  of the bark,  with  the  elixir of vitriol,
and take frequently a glafs of generous wine. Thefe, together with
a milk-diet, and ridir^ on horfeback, are moft likely for recover-
ing his ftrength. 
C   2°5  1
        The Cynanche Parotidaa ;  Or, the Mumps.

  THIS difeafe is known, in America, under the appellation of
the mumps : It is more particularly incident to children than to
grown people ;  and afflicts  the patient but once in  his life :  It is
thought to be produced by contagion.
  SYMPTOMS.----It comes on with a moderate fever : this is
foon followed with a ftiffnefs in  the neck, and a Swelling  about
the angle of the lower jaw. In a  fhort time, the Swelling increaSes,
and affeas the whole neck ; Sometimes one fide only is affeaed,
but generally both.  It is not unSrequently attended with a flight
difficulty in Swallowing.  Thofe fymptoms continue to  increafe
until the third or fourth day. At length the fever Subfides, the Swel-
ling recedes Srom the throat and neck ; and  the tefticles in men,
and the breafts  in women, become affeaed in a Similar manner :
for the moft part, this gradually disappears without much inconve-
nience ; but when the Swelling does not come on after that of the
throat and neck, the fever often becomes confiderable.
  REGIMEN.----This complaint feldom requires much atten-
tion ; the patient  muft confine  himSelf  to the houfe. The neck
fhould be  defended from cold, by the application of flannel.  The
diet fhould be fpare, and the drink diluting.
  MEDICINE.----The parts about the neck may be bathed with
a mixture, confifting of halS a  table-SpoonSul  of  fweet-oil, and
Sixty drops of  laudanum.  The  bowels muft be kept  open with
cream of tartar and flower of fulphur : but when the tumour has
fuddenly receded from the throat, in confequence of cold, or any
other caufe,  and the fever becomes confiderable, with  pain in the
head, a full and hard pulfe, blood muft be taken from the arm,
and repeated as the fymptoms may demand. A blifter may alfo be
applied to the fore or back part of the neck.
               CHAPTER   XXXI.

                   Of Colds  and  Coughs.

     COLDS are the effea of an obftruaed perfpiration : Almoft
      every cold is a kind of fever, which  only differs in degree
from fome of thofe already treated of.
  No age, fex, or conftitution, is exempted from this difeafe
neither can any medicine or regimen prevent it. The inhabitants;
of every climate are liable to catch cold, nor can the greateft cir-
cumfpeaion defend them  at all  times from  its attacks. Indeed, 
206         OF COUGHS AND  COLDS.

if the human body could be kept conftantly in an uniform degree  ,
of warmth, catching cold would be impoflible :  but as that cannot
be effedted by any means, the perfpiration muft be liable to many
changes. Such changes, when fmall, do-not affedt the health; but,
when great, they muft prove hurtful.
  When oppreffion of the breaft, a fluffing of the nofe, unufual
wearinefs, pain of the head, &c. give ground to believe that  the
perfpiration is obftruaed,  or, in other words, that the perfon has
caught cold,  he ought immediately to leffen his diet, at leaft the
ufual quantity of his folid food, and to abftain  from all ftrong li-
quors. Inftead oS flefh, fifh, eggs, milk, and other nourifhing diet,
he may  eat light bread-pudding, veal or chicken  broth, panado,
gruels,  a.;d  Such-like.  His. drink may be  water-gruel Sweetened
with a little honey ; an infufion of balm or tin feed; fharpened. with
the juice of orange or lemon ;  a decoaion  of barley and liqu@rice,
with tamarinds, or any other cool, diluting, acid liquor.  His fup-
per fhould be light; as  Small poffet or water-gruel, Sweetened with
honey, and a little toafted bread in it. If honey difagrees with the
ftomach, the gruel may.be fweetened  with  treacle  or coarSe Sugar,
and fliarpened with  the jelly oS currants.   i'hoSe who have been
accuftomed to generous liquors, may take wine-whey inftead of
gruel, which may be Sweetened as above.
  The patient ought  to lie longer than ufual a-bed, and to encou-
rage a gentle fweat, which  is eafily brought on towards morning,  I
by drinking tea, or any  warm diluting liquor. I have oSten known
this praaice carry off a cold in one day, which, in all probability,
had it been negfeaed, would have coft the patient his liSe, or have
confined him Sor Some months.  Would  people  Sacrifice a little
time to eaSe and warmth, and pradtife a moderate degree oS absti-
nence when the firft Symptoms of a  cold appear, moft of the bad
effeas which flow from an obftruaed  perSpiration might be  pre-
vented.  But, after the difeafe has gathered ftrength by delay, all
attempts to remove it often  prove vain.  A pleurify, a peripneu-
mony, or a fatal confumption of the lungs, are the common effects
of  colds, which have either been totally negfeaed or treated im-
properly.
   Many attempt to cure a cold, by getting drunk. But this, to fay
no worfe of it, is a very hazardous experiment. No doubt  it  may
fometimes  fucceed,  by fuddenly restoring the perSpiration;  but
when there is any degree  of inflammation, which  is frequently the
cafe, ftrong liquors, inftead of removing  the malady, increaie.it.
By this means, a common  cold may become an inflammatory fever.  {
    When thofe who  labour for their daily bread catch cold, they j
 cannot afford  to lofe a day or two,  in order to keep  themfelves ■
 warm, and take a little medicine ;  by which means, the diforder is  !
 often fo aggravated, as to  confine them for a long time, or'even
 to render them ever after unable to fuftain hard labour. But even 
OF  COUGHS  AND  COLDS.         207
fuch of the labouring poor as can afford to take care of themfelves,
arc often too hardy to do it: they affea  to difpife colds, and as
long as they can crawl about, fcorn to be confined by what they
call a common cold. Hence, colds deftroy fuch numbers of man-
kind. Like an enemy defpifed, they gather ftrength from delay, till
they become invincible.  Often  travellers,  rather than lofe a day
in the  proSecution oS their bufinefs, throw away their lives by pur-
Suing their journey, even in the Severeft weather,  with this difeaSe
upon them.
   Colds may alSo be too much indulged. When a perfon, for eve-
ry flight cold, fliuts himSelf up in a warm room,  and drinks great
quantities of warm liquor, it may occafion  fuch  a general relax-
ation of the folids as will not be eafily removed.  It is, therefore,
proper, when the difeafe will permit, and the weather is mild, to
join to the regimen mentioned above, gentle exercife ; as walking,
riding on horieback, or m a carriage. &c.  An obflinate cold, which
no medicine can  remove, will yield to gentle exercife and a pro-
per regimen of the diet.
   Bathing the feet and legs in warm  water has a great  tendency
 to reftore perfpiration.  But care muft be taken that the water  be
 not too warm, otherwife it will do hurt.  It fhould never be much
 warmer than the blood, and the patient fhould go immediately to
 bed after ufing it. Bathing the feet in warm water, lying in bed,
 and drinking warm water-gruel, or other  weak liquors,  will foon-
 er take off a fpafm, and reftore the perfpiration, than all the hot  fu-
 dorific medicines in the world.  This is all that is neceffary for  re-
 moving a common cold ;  and if this courfe be taken at the begin-
 ning, it will feldom fail.
   But when the fymptoms do  not  yield  to  abftinence, warmth,
 and diluting liquors, there is reafon to fear the approach of fome
 other difeafe ; as an inflammation of the breaft, an ardent fever, or
 the like. If the pulfe, therefore, be hard and frequent, the fkin hot
 and dry, and the patient complains of his head or breaft, it will be
 neceffary to bleed, and to give the cooling powders recommended
 in the Scarlet fever, every  Three or four hours, till they give a (tool.
    It  will likewife be  proper to put a  blifter on the back, to give
 two table-fpoonfuls of the faline mixture every two hours, and,
 in fhort, to'treat the patient in all reSpeas as Sor a flight Sever. I
 have  often lecri this courfe, when obServed at the  beginning, re-
 move the complaint in two or three day, when the patient had all
 the Symptoms of an approaching ardent fever, or an inflammation
 of the breaft.
    The chief fecret of preventing colds,  lies in avoiding, as far as
 poffible, all extremes  either of heat or cold, and  in taking care,
 when the body is heated,  to let it cool gradually. Thefe and other
 circumftances relating to  this important fubjea, are fv.Hy  treated
 of, under the article Obflnuled Perfpiration. 
208
                    Of a Common Cough.

   A cough is generally the effea of a cold, which has either been
 improperly treated,  or entirely negfeaed.  When it proves obfli-
 nate, there is always reafon to fear the confequences, as this fliows
 a weak ftate  of the lungs, and is often the forerunner of a con-
 Sumption.
   If the cough be violent, and the patient young and ftrong, with a
 hard quick pulfe, bleeding will be proper; but in weak and relaxed
 habits, bleeding rather prolongs the diSeaSe.   When the  patient
 fpits Sreely, bleeding is unneceffary, and fometimes hurtful, as it
 tends to leffen that difeharge.
   When the cough is not attended with any  degree of fever, and
 the  fpittle  is vifeid and tough, Sharp peaoral medicines  are to be
 adminiftered ;  as gum  ammoniac, Squills, &c.  Two table-fpoon-
 fuls of the Solution  of the gum ammoniac may be taken  two or
 three times a-day, more or lefs, according to  the age and conftitu-
 tion of the patient. Squills may be given various ways :  two oun-
 ces of the vinegar, the oxymel, or the  fyrup, may be mixed with
 the fame quantity  of fimple cinnamon-water, to which may be ad-
 ded, an ounce of common water and an ounce of  balfamic fyrup.
 Two table-fpoonfuls of this mixture may be taken  three or four
 times a-day.
   A fyrup made of equal  parts of lemon-iuice, honey, and fugar-
 candy, is likewife  very proper in this kind  of cough.  A table
 Spoonful of it may be  taken  at pleafure.
   When the defluxion is Sharp and thin, thefe medicines rather do
 hurt.  In this cafe, gentle  opiates, oils, and  mucilages, are more
 proper.  A cup of an inSufion oS  wild poppy leaves, and  marfh-
 mallow roots, or the flowers of colts-foot, may be taken frequent-
 ly ;  or a tea-Spoonful of the  paregoric elixir may be put into the
 patient's drink  twice a-day.
   When  a cough is occafioned by acrid humours,  tickling the
throat and  Sauces, the patient fhould keep Some  SoSt peaoral  lo-
 zenges almoft conftantly in his mouth ; as the liquorice cakes, bar-
ley-Sugar,  the  common balfmatic  lozenges, Spanifh juice, &c.
Thefe  blunt the acrimony of the humours, and, by taking off their
Stimulating quality, help to appeaSe the cough*.

  * In a former edition, I recommended, for an obflinate tickling cough,
an oilyeniuUion, made with the paregoric elixir of the Edinburgh Dif-
penCatory, inlread of the common alkaline fpirit. I have ilnce been told
by feveral practitioners, that they found it to be an excellent medicine
in this  diforder, and every way  deferving of the charafter which I had
fcjven it. Where this elixir is not kept, its place may be fupplied by ad-
ding to the common oily emulfion, an adequate proportion of the The-
baic tmihire, or liquid laudanum. 
              OF A COMMON COUGH.         £09

  In obflinate coughs, proceeding from a flux of humours upon
the lungs, it will often be necefiary,  befides  expeaorating medi-
cines, to have recourfe to iflues, fetons, or fome other drain*.  I
have often obferved the moft happy effeas from a Burgundy-pitch
plafter applied between the fhouklers. I have ordered this fimple
remedy in the moft obflinate coughs, in a great number of cafes,
and in many different conftitutions, without  ever knowing it Sail
to give relieS, unleSs where there were evident Signs of an ulcer in
the lungs.
   About the bulk of a nutmeg of Burgundy-pitch, may be fpread
thin upon a piece  of foft leather, about the fize of the hand, and
laid between the fhoulder-blades.  It  may be taken off and wiped
every three or four days, and ought to be renewed once a fortnight
or three weeks.  This  is, indeed, a cheap and fimple medicine, and
confequently apt to be defpifed ;  but the materia medica does not
afford an application  more efficacious  in almoft every  kind o£
cough. It has not indeed always  an immediate effea ; but, if kept
on  for fome time, it will fucceed where moft other medicines
fail.
  The only inconveniency attending this plaifter, is the itching
which it occafions; but furely this may be  difpenfed with, con-
sidering the advantage which the patient may expea to reap from
the application.  When the  itching becomes very uneafy, the plaif-
ter may be taken off, and the part rubbed with a dry cloth, or wafh-
ed with a little warm milk and water.  Some caution is neceffary
in difcontinuing the ufe of fuch a plaifter; this, however, may be
fafely done by making it Smaller by degrees, and at length  quit-
ting it altogether in a warm feafonf.
  But coughs proceed Srom many other cauSes befides defluxions
upon the lungs.  In theSe caSes,  the cure is not to be attempted by
peaoral medicines.  Thus, in  a cough proceeding from a foulnefs
and debility of the ftomach, fyrups, oils, mucilages, and all  kinds o£
balfamic medicines do hurt.  The fomach cough  may be known,
from one that is owing to a fault in the lungs, by  this, that in the
latter the patient coughs whenever he infpires, or draws in his
breath fully;  but in the former, that does not happen.
  The cure of  this cough depends  chiefly  upon cleanfing and
Strengthening the ftomach ; for which purpofe, gentle vomits and
bitter purgatives are moft proper.  Thus, aSter a vomit or two,
the Sacred tinaure, as it is  called, may be taken for a confiderable

  * The patient fliould  wear flannel next his fkin, in order to promote
perfpiration.    (I. C.)
  t Some complain  that the pitch plaifter adheres too faff, while others
find difficulty in keeping it on. This proceeds from the different kinds
of pircb made ufe of, and likewife from  the manner of making  it. I ge-
nerally find it anfwers beft when  mixed with  a little bees-wax, and
fpread as cool as poffible. The clear, hard, tranfparen: pitch anfwers the
purpofe beft,
                             D  2 
 -io        OF THE WHOOPING-COUGH,

 time, in the dofe of one or two table-fpoonfuls, twice a-day, or as
 often as it is found neceffary to keep the body gently open.  People-
 may ma-Ice this tiifeture themfelves, by infufing an ounce  of hiera
pier a* in an Engliih  pint of white wine,  lertijjg  it Hand a fe-.v
 days, and then ftraining it.
   Li coughs which proceed  from  a debility of the ftomach,  the
 bark is likewife of confiderable fervice. It  may cither be chewed,
 taken in powder, or made into a tinaure along with other ftoma-
 ch ic bitters.
   A nervous cough can only be removed by change-of air, proper
 exercife, and gentle opiates.  Inftead of the Saponaceous pill,  the
 paragoric elixir,  &c.  which are only opium dilguifed, ten, fifteen,
 twenty, or twenty-five drops of liquid laudanum, more  or lefi,
 as circumftances require, may be taken at  bed time, or when  the
 cough is moft troublefome. Immerfing the  feet and hands in warm
 water will often appeafe the violence of a  nervous cough.
   When a cough is only the fymptom of  fome other nialadv, it
 is in vain to attempt to remove i*, without firft curing the difeafe
 from which it proceeds.  Thus, when a  cough  is occafioned by
 teething,  keeping the body open, Scarifying the gums, or whatever   \
 facilitates  the cutting of the teeth, likewife appeafes the cough.
 in4ike manner,  when worms occafion a cough, Such medicines as
 remove thefe vermin will generally curt the cough * as bitter pur-
 gatives, oily clyfters, and Such like.
   Women during the laft months oS pregnancy,  are often great-
 ly affhaed with  a cough, which is generally relieved by bleeding, ;.?
 and keeping the body gently open.   They ought to avoid all flatu-
 lent food, and to wear a loofe eafy drefs.                        \
   A  cough is  not only a Symptom, but is  often- likewife the fore-*
 runner of  difeafes.   Thus,  the gout is frequently ufhered in by
 a very troubleSome cough, which affeas the patient Sor Some days.
 before the coming on of the fit. '1 his cough is generally removed
 by  a paroxySm of the gout,  which fliould  therefore be promoted,
 hy  keeping the  extremities  warm, drinking  warm liquors,  and
 bathing the feet  and legs frequently in lukewarm water.
          Of the Whooping-Ccugh, or Chin-Cough.

  'I his cough  Seldom affeas adults, but proves often fatal to ch.il-
<":en.   Such children as live upon thin watery diet, who breathe,
.-•wholefome air, and have too little exercife, arc mod liable to
  is difeaSe, and generally Suffer moft Srom it.
  The chin-cough is  So well known, that a description of it is un-
.wveffcry.   Whatever hurts the d.feel'iicn,  obftruas the perfpira-

                *See .".pp;::d;;i,. Hiera r'.ra. 
                OR CHIN-COUGH*               jan

tion, or relaxes She folids, difpofes to this difeafe :  consequently,
its cure muft depend upon cleanfing and lengthening the ftomacn,
bracing the Solids, and at the Same time promoting perSpiration and
the different Secretions.
   The diet muft be light, and cf eaSy digeftion; Sor children,
good bread  made into pap or pudding, chicken-broth, with other
light Spoon-meats, arc proper ;  but  thoSe who are  farther ad-
vanced, may be allowed Sago-gruel, and  iS the fever be not high, a
little boiled chicken,  or other  white  meat?.  The^rink may be
hyffop, or pennyroyal tea, fweetened with honey or Sugar-candy,
Small wine-whey;  or, if the patient  be  weak,  he may fometimes
be allowed a little negus.
   One of the moft effedlual remedies in  the chin-cough, is change
of air. This often  removes the malady,  even  wher^the change
feems to be from a purer to a leSs wholeSome air.  This  may in
fome meafure depend on the patient's being removed from the place
where the infeaion prevails.   Moft of the difeafes  of children are
infeaious ; nor is it at all uncommon to find the chin-cough pre-
vailing in one town or village, when another,  at a very fmall dis-
tance, is  quite  free from it.   But whatever be the caufe,  we are
 fure  of the fa6l.  No time ought therefore to be loft in removing
the patient  at fome diftance from  the place where  he caught the
difeafe, and,  if poffible, into a more pure and warm air*.
   When  the difeafe proves violent,  and the patient is in danger
of being  Suffocated by the cough, he ought to be Wed, efpecially
if there be a fever with a hard full puife.   But as the chiet inten-
tion  of bleeding is to prevent an inflammation of  the lungs, and
to render it more Me to give vomits,  it  is  feldom necefiary to re-
 peat the operation ;  yet if there are fymptoms of an inflammation
of the lungs, a fecond or even  a third bleeding may  be requihte.  ^
   It is generally reckoned a  favourable fymptom when a fit o,
 coughing makes the  patient  vomit.   This cleanfes the ftomach,
and greatly relieves the cough.  It will therefore be proper to pro-
 mote this difeharge,  either by fmall  dofes of ipecacuanha, or the
 vomiting julep recommended  in the Appendixf.
   It is very difficult to make children drink after a vomit.  I have
 often feen them happily deceived, by infufing a feruple or half a
 drachm of  the powder of ipecacuanha  in a tea-pot,  with half an
 Englifh pint of boiling  water.   If this be difguifed with a lew
 drops of milk and a little fugar, they will imagine it tea, and dnnu
 it very greedily.  A fmall tea-cupful of  this may be given every

    * Rome think the air ou5ht not to be chan^d till  the difeafe  is
 on the decline ;  but there feems to be no fufficient reafon for this opinion
 as patients have been known to  reap benefit from ?. change or air a. all
 periods of the difeafe.  It is not fufficient to take the par.en, <nu daily
 in a carri:.-e.   This feldom anfwers any good pirpoie ; but often uoe ■
 hurt, by pivinc; him cold.
                t  ^ce Appendix, Vom't-ng Jufep- 
2i2       OF THE WHOOPING-COUGH,  &c.

quarter of an hour,  or rather every ten minutes, till it operates.
When the child begins to puke, there will be no occafion for drink-
ing any more, as the water already on the ftomach will be fufficient.
   Vomits not only cleanfe the ftomach, which  in  this difeafe is
generally loaded with vifeid phlegm, but they likewife promote the
perfpiration and other fecretions,  and ought therefore to be repea-
ted according to  the obftinacy of the difeafe.   They fhould not
however be Strong : gentle vomits frequently repeated are both lefs
dangerous, and more beneficial than ftrong ones.
   The body  ought to be kept gently open.   The beft medicines
for this purpofe are caftor oil, or flour of  fulphur  and cream of
tartar.  Thefe muft be given in Small doSes, and  repeated as occa-
fion requires.
   Many people believe that oily, pectoral, and balSamic medicines
poffeSs wonderful virtues for the cure of the chin-cough, and ac-
cordingly exhibit them plentifully to patients of every age and con-
ftitution, without considering that every tiling oS this nature muft
load the ftomach,  hurt the digeftion, and of courfe, aggravate the
diforder*.
   Opiates are Sometimes neceffary to allay  the violence of the
cough.   For this purpofe, a little of the fyrup of poppies, or five,  '
fix, or feven  drops of  laudanum, according to the age of the pa-
tient, may be taken  in a cup of hyffop, pennyroyal tea,  or.fugar
and water, and repeated occafionallyf.
   The garlic ointment is a well-known remedy  in  North-Britain
ior the  Chin-cough.   It is made by beating, in a mortar, garlic,
with an equal quantity of hogs-lard. With this, the foles of the
feet may  be rubbed twice or  thrice a-day;  but the beft method is  ,
to fpread it upon a rag, and  apply it in the form of plaifter. It
fhould be renewed every night and  morning at leaft, as the garlic
foon lofes its virtue.   This is an  exceeding good medicine, both
in the chin-cough and in moft other  coughs of  an obflinate na»
ture.   It ought not however to be ufed when the patient is very
hot or feverifh, left it fhould increafe thefe fymptoms.
   The feet fliould be bathed once every two or three days in luke-
warm water; and a  Burgundy-pitch plaifter kept conftantly be-
tween the fhoulders.   But when  the difeafe proves very violent,
it will be  necefiary, inftead of it, to apply a blifter,  and to keep
the part open for fome time with  iffue-ointment.

  •5f  Dr. Duplanil fays, he has feen  many good effects from the kermes
mineral  in this complaint, the  cough being frequently alleviated even  j
by the firft dofe.  The dofe for a child of one year old, is a quarter of  a
<r,rain diffolved in a cup of any liquid, repeated two or three times a-day-
For a child of two years, the dofe is half a grain ; and the quantity muft •
be thus increafed, in proportion to the age of the patient.
  + Some recommend the extract of hemlock as an extraordinary reme-
dy in the whooping-cough ; but fo far as I have been able to obferve, it
is no wdy fuperior to opium,  which, when properly  adminiilered, will
often relieve fome of the moft troublefome fymptoms of this diforder. 
      INFLAMMATION  OF THE STOMACH, si3
                                    »                  —■■■—-■■-»
  When the difeafe is prolonged,  and the r.tinf is free from a
fever, the bark, and other bitters, are the moft proper medicines.
The bark may either be taken in fubftance, or in a decocddon or
infufion, as is mofl agreeable.  For a child, ten, fifteen, or twenty
grains,  y.ccording to the age of the patient,  may be given three
or four  times a-day.  For an adult, half a drachm or two feruples
will be  proper.  Some give  the extract of the bark with cantha-
rides ;  but to manage this, requires a confiderable attention,  It is
more  fafe to give a few grains  of caftor along with the bark.   A
child of fix or Seven ye?.rs of age, may take leven or ei^ht grains
of caftor, with iifreen grains of powdered bark, for a dofe. This
may be  made into a mixture with two or three ounces oS any Sim-
ple diftilled water, and a tittle  Syrup, and  taken three or four
times a-day.
              CHAPTER   XXXII.

      Inflammation of the Stomach, and other Vifcera*

      ALL inflammations of the bowels are dangerous, and require
       the  mcit fpeedy affiftance ; as they Srequently end in a Sup-
puration, and Sometimes in a mortificarion, which is certain death.
   CAUSES----An inflammation of the ftomach may proceed
from any of the caufes which produce an inflammatory, fever ; as
cold liquor drank  while the body is warm, obftrucled perfpiration,
or the fudden ftriking in of any  eruption. It may likewife proceed
from the acrimony of the bile, or from acrid and Stimulating Sub-
Stances taken  into the ftomach ; as ftrong vomits or purges, cor-
rofive poiSons, and Such-like.  When  the gout has been repelled
Srom the extremities, either by  cold or improper applications, it
oSten occafions an inflammation of the ftomach. Hard or indigef-
tible fubftances taken into the ftomach,  as bones,  the ftones of
fruit, Sic. may likewife have that effect.
   SYMPTOMS.----It is attended with a fixed pain andburning
heat in the ftomach ; great reftleffnefs and anxiety ; a Small,  quick,
hard pulfe ; vomiting, or, at leaft,  a naufea and ficknefs ; exceffive
thirft ; coldnefs of the extremities ; difficulty of breathing ; cold
clammy fweats •, and fometimes  convulfions and fainting fits. The
ftomach  is fwelled, and oSten  Seels hard to the touch.  One  oS the
moft certain figns oS this diSeaSe is, the Sr-iSe of  pain, which the
patient feels upon taking any kind of  food or drink, efpecially if it
be either too hot or t.vo cold.
  When  the patient vomits every thing he eats or drinks, and is ex-
tremely rcStlefs, has a hiccup, with an intermitting  pulSe, or Sre-
.quent fainting fits, the danger is very great.
   REGIMEN.----All acrimonious, heating, and irritating food 
 214    INFLAMMATION OF THE STOMACH.

 and drink are carefully to be avoided. The weaknefs of the pati-
 ent may deceive the by-ftanders, and induce them to give him
 wines, fpirits, or other cordials ;  but thefe never fail to increafe
 the difeafe, and often occafion  fudden death.  The inclination to
 vomit  may likewife impofe on the  attendants,  and make them
 think a vomit necefiary ; but that too is almoft certain death.
   The Sood  muft be light, thin,  cool, and eaSy of  digeftion. Tt
 muft be given in Small quantities, and fliould neither be quite cold
 nor too hot.  1 hin gruel made of barley or oatmeal,  light roafted
 bread diflolved in boiling  water, or very weak chicken-broth, are
 the moft proper. The  drink fhould be clear whey, barley-water,
 water in which toafted  bread  has been boiled,  or  decottions of
 emollient vegetables; as liquorice and marfh-mallow roots, Sar-
 faparilla, &c.
   MEDICINE.----Bleeding in this difeafe isabfolutely neceffary,
 and is almoft the only thing that can be depended on. When the
 diSeaSe proves obflinate, it will oSten be proper to repeat this ope-
 ration Several times, nor muft the low ftate oS the pulSe deter us
 from doing So.  The pulSe, indeed, generally rifes  upon bleeding,
 and as long as that is the caSe, the operation is Safe.
   Frequent fomentations with lukewarm water,  or a decoction of
 emollient vegetables, are likewife benefici.il. Flannel cloths dipped
 in theSe muft be applied to the region of the ftomach, and removed
 as they grow cool.  They muft neither  be applied too warm, nor
 be fuffered to continue  till they become quite  cold,  as either of
 thefe extremities  would  aggravate the difeafe.
   The  feet and  legs ought  likewife to be frequently bathed in
 lukewarm water, and warm  bricks or poultices may be applied to
 the foles of the feet. The warm bath, if  it^can  be  conveniently
 ufed,  will be of great fervice.
   In this, and all other inflammations of the bowels, an epifpaftic,
 or blifter, applied over the part  affected, is one oS the beft reme-
 dies. I have oSten uSed it, and do not recollect one inftance where-
 in it did not give relieS to the patient.
   The only internal medicines which we venture to  recommend
 in this diSeaSe, are mild  clyfters.  TheSe may be made oS warm
 water, or thin water-gruel;  and iS the patient is coftive,   a little
 Sweet-oil, honey, or manna,  may  be added.  Clyfters anfwer the
 purpofe of an  internal fomentation, while they keep the body open,
 and at the fame time nourifii the patient, who is oSten in this diS-
eaSe unable to retain any Sood upon his ftomach. For theSe rea-
sons, they muft not be neglected, as the patient's  liSe may  depend
on them. 
C   an   ]
               Inflammation of the Inteflines.

  THIS is  one of  the moft  painful and dangerous difeafes that
mankind are liable to. It  generally proceeds from the fame caufes
as the  inflammation of  the  ftomach ;  alfo,  from  coftivenefs,
worms, eating unripe Sruits, or great quantities oS nuts, drinking; •
hard windy malt liquors,  as Hale bottled beer or ale,  Sour wines,
cyder,  Sec. It  may likewiSe be occafioned by a rupture, by fehir-
rous tumours oS the inteftines, or by their oppofite fides growing:
together.
  The inflammation of the inteftines is denominated Iliac Paffion 9
Enteritis, &c.  according to the name  of the parts affected. The
treatment is nearly the fame whatever part of the inteftinal canal
be the  feat of  the diSeaSe ; we fhall thereSore omit  theSe diftinc-
tions, left they fhould .perplex  the reader.
  The fymptjins here are nearly the Same as in the foregoing diS-
eaSe ; only the  pain, if poffible, is more acute, and is  Situated low-
er.  The vomiting is likewiSe more violent, and Sometimes even the
excrements, together with the clyfters and SuppoSitories, are dis-
charged by the mouth. The  patient is  continually  belching up
wind, and has often an obfbruction oS his urine.
  While the pain Shifts, and the  vomiting only returns at certain
intervals, and while the clyfters pafe downwards, there is ground
to hope ; but when  the clyfters and faces are vomited, and the pa-
tient is exceeding weak, with  a low,  fluttering pulSe, a pale  coun-
tenance, and a diSagreeabfe or ftinking breath,  there is^reat rea-
fon  to fear that the confequences will prove fatal. Clammy Sweats,
black foetid ftools, with a fmall  intermitting pulfe,  and a  total
ceffetion of pain, are figns of  a mortification already begun, and
of approaching death.
  REGIMEN.----The  regimen is in general the fame as  in aw
inflammation of the itomach. The  patient muft be  kept  quiet,
avoiding cold, and all violent  pafflons of the mind. His food ought
to be very light, and given in  fmall quantities ; his drink weak and
diluting ;  as clear whey,  barley-water, and fuch-like.
  MEDICINE.----Bleeding in this, as  well as  in the inflamma-
tion of the ftomach, is of the greateft importance.  It fliould  be
performed as foon as the  fymptoms appear, and m-uft  be repeated
according to the ftrength of the  patient, and the violence of the
difeafe.
  A blifter is  likewife'to be  applied  immediately over the part
where  the molt violent pain is. This not only relieves the pain of
the  bowels, but even clyfters  and purgative medicines, which be-
Sore had no effect, will operate when the blifter begins to rife.
  Fomentations and laxative  clyfters are by no  means to be omit-
ted. The patient's feet and legs fhould frequently be bathed  in
warm wuivr;  and  cbths digped hi  it uppil-d to his  belly. Bhd- 
 ai6   INFLAMMATION OF THE INTESTINES.

 ders filled with warm \v«.tcr may iikewiSe be applied to the region
 of the navel, and warm bricks, or bottles fiifed with warm water,
 to the Soles oSthe iert. The clyfters may be made oS barley-water
 or thin ~ruel with fedt, and Softened with fweet oil or frefh butter.
 Thefe may be adndri.tercd every two or three hours, or oftener,
 if the patient cunti  rues coftive.
   II the difeaSe does not yield to  clyfters and fomentations, re-
 ceurfe muft be h ti  to pretty ftrong purgatives; but as  thefe,  by
 irritating the bowels, often increafe their contraction, and by that
 means, frustrate their own intention, it  will be neceffary to join
 them whh opiates, which, by alloying the pain, and relaxing the
 fpaSmrHic contractions of the guts, greatly affift the operation of
 purgatiies.
   What anfwers the purpofe of opening the body very well, is a
 Solution of the bitter purging Salts.   Two ounces oS  theSe  may be
 diffolved in an Englifh pint of warm water, or thin gruel, and a
 teacupful of it taken every half hour till it operates. At the fame
 time, fifteen, twenty, or twenty-five drops  of  laudanum  may be
 given in a gidfs  of pepper nint or fimple cinnamon-water, to ap-
 peaSe the irritation, and prevent the vomiting, Sec.
   Acids have often a very happy  effect in flaying  the  vomiting,
 and  appealing the other viofent Symptoms of this difeafe.  It will
 therefore be of ufe to Sharpen  the  patient's drink  with  cream of
 tartar, juice of lemon ; or, when  thefe  cannot be obtained, with
 vinegar.
   But it often happens that no  liquid whatever will Stay on the
 ftomach. In this cafe, the patient muft take purging pills.  I have
 generally Sound  the following anSwer very well : Take jalap in
 powder, and vitriolated tartar, of each half  a  drachm, opium one
 grain, Caftile Soap  as much  as will make the  mafs fit Sor pills.
 TheSe muft be taken at one doSe, and iS they do not operate in a
 few  hours, the doSe may  be repeated.
   IS a ftool cannot be procured by  any of the above  means, it will
 be neceffary  to  immerfe  the patient in warm water up to the
 breaft.  I have oSten Seen this Succeed when other means had been
 tried in vain. The patient muft continue in the water as long as
 he can eafily bear it without fainting, and if one  immerfion has
 not the defired effect, it  may be repeated as foon as the patient's
 ftrength and  fpirits  are recru'ted.  It  is  more  fafe for him to go
frequently into the bath, than to continue too long at a time ; and
 it is often necefiary  to repeat it feveral times before  it has the de-
 fired effect.
  It has fometimes happened, after all other means  of procuring
a ftool had been tried to no purpofe, that this  was brought about
by immerfing the patient's lower extremities  in  cold  water, or
making him walk upon a wet pavement,  and dafliing his legs and
thighs with cold water.   This method, when others fail, at leaft 
                    OF THE  COLIC.                 217

merits a trial.  It is indeed attended  with fome  danger ; but  a
doubtful remedy is better than none.
  In defperate cafes, it is common to give quick Silver. This may be
given to the quantity oS Several ounces, or even a pound,  but
Should not exceed that .  When there is  re 1 Son to SuSpect a mor-
tification of the  guts, this medicine ought not to be tried. In that
cafe, it cannot  cure  the patient,  and  will only haften his death.
But when the obstruction is occafioned by any caufe that can be
removed by force, quickfilver is not only a proper  medicine, but
the beft that can be  adminiftered, as it is the fitteft body wc know
Sor making its way through the inteftinal canal.
   IS the difeaSe proceeds Srom a  rupture, the patient muft be laid
with his head very low, and the inteftines returned by gentle pref-
Sure with the hand.  If this, with fomentations and clyfters,, fhould
not fucceed, recourfe muft be had to a furgical operation,  which
 may give the patient relief.
   Such as would avoid this excruciating and  dangerous difeafe,
 muft take care never to be too  long without a ftool.  Some who
 have died of it,  have had feveral pounds of hard dry faeces taken out
 of their guts. They fhould likewife beware of eating too freely of
 four or unripe fruits, or drinking ftale windy liquors.  &c. I  have
 known it brought on by living too much on  baked fruits, which
 are feldom  good.  It likewife proceeds frequently  from cold caught
 by wet clothes, &c. but efpecially from wet feet.
                        Of the Colic.

  THE colic has a great refemblance to the two  preceding dif-
eafes, both in its fymptoms and method of cure.  It  is generally
attended with coftivenefs and acute pain of the bowels; and re-
quires diluting diet, evacuations, fomentations, &c
   Colics are varioufly denominated according to  their caufes, as
the flatulent■, the  bilious,  the hyferic, the nervous, &c  As each of
thefe require a particular method of treatment, we fhall poinjt out
their moft general fymptoms, and the means to be'.ufed for their
relief.
   The flatulent,  or wind-colic, is generally occafioned by an indif-
creetufe of unripe fruits, meats of hard digeftion, windy vegeta-
bles, fermenting liquors, and fuch like. It  may likewife proceed
from an obftructed perfpiration, or catching cold. Delicate people,
whofe digeltive powers are weak, are moft liable to this kind of colic.

   *• When quickfilver is  given in too large quartities,  'ft defeats its
own intention, as it pulls down the bottom of rhe ftomacM^ which pre-
vents it getting over the pylorus. In this cafe,the patient fhould be hung
up by the heels, in order  that the quickfilver may be  difcharged by his
month.                                                "\
                              E  a 
  liS                OF  THE  COLIC.

    The flatulent colic may either affect the ftomach or inteftines,'
  It is attended with a painSul ftretching oS the affected  part. The
  patient feels a rumbling in his guts, and is generally relieved by a
  difeharge of wind, either upwards or downwards.  The pain is Sel-
  dom confined to any particular part, as the vapour wanders from
  one divifion of the bowels to another till it finds a vent.
    When the difeafe proceeds from windy  liquor, green  fruit,
  four herbs, or the like,  the beft medicine, on the firft appearance
  of the fymptoms, is a dram of brandy, gin,  or any good fpirits.*
  The patient fhould likewife fit with his feet  upon a warm hearth
  ftone, or apply warm bricks to  them ; and warm cloths  may be
  applied to his ftomach and bowels.
    'I his is the only colic  wherein ardent fpirits,  fpiceries, or any
  thing of a hot nature,  may  be  ventured  upon.  Nor indeed  are
  they to be ufed  here unlefs at  the very beginning,  before any
  fymptoms of inflammation appear. We have reafon to believe, that
  acolic, occafioned by wind or flatulent Sood, might always be cur-  •
  ed by Spirits and warm liquors, if taken immediately upon  per-
  ceiving the firft  uneafineSs;  but when the pain has continued for
  a confiderable time, and there is  reaSon to fear an inflammation of
  the bowels already begun, all hot things are to be avoided as poifon,
  and  the patient is to be treated in the fame manner as for the in-
  flammation of the inteftines.
    Sevsral  kinds of  food, as  honey, eggs,  &c. occafion  colics in
  fome particular conftitutions. I have generally found the beft me-
  thod of cure for thefe was, to drink plentifully of  fmall diluting
  liquors, as  water-gruel, Small poffet,  water  with  toafted bread
  Soaked in it, Sec.
    Colics which proceed  from excefs  and  indigeftion,  generally
  cure themfelves, by occafioning  vomiting or purging. Thefe dis-
 charges are not to be ftopped, but  promoted by drinking plenti-  \
 Sully of warm water, or weak poffet. When their violence is over,
 the patient ma\ take a dofe of falts or caftor-oil, to carry off the  <
 dregs of his debauch.
   Colics occafioned by wet  feet, or catching cold,  may  generally
 be removed at the  beginning, by bathing the feet and legs in warm
 water, and drinking fuch warm diluting liquors as will promote
 the perfpiration, as weak wine-whey, or water-gruel, wl'-h a fmall  .
 quantity of fpirits in  it.
   Thofe flatulent colics,  which prevail fo much among country
 people, might generally  be prevented,  were they to change their
 clothes w!un they get wet.  They ought likewife to take a dram,

  * Thefe generally afford relief, but the greateft difadvantage attend-  ;
ing this  \ atMce is, that the patient is apt to become intoxicated, and
liable to dde^nto the practice of frequent inebriation. On this account,
a dofe of laiTdanum may be fubftitutcd, which is not quite fo fafcinating
to the palate, as for the patient to wiUia repetition, without an abfolute
neceffit.y."    (1. C.) 
                    OF THE COLIC.                219

ot drink fome warm liquor after eating any  kind  of green trafli.
We  do not recommend dram-drinking, but in this cafe, fpirits
prove a real medicine, and the beft  that can be adminiftered.  A
glafs of good pepper-mint water will have nearly the fame effect
as a glafs of brandy, and, in fome cafes, is rather to be preferred.
.   The bilious colic is attended with very acute pains  about the re-
gion of the navel.  The patient complains of great thirft, and is ge-
nerally coftive.  He vomits  a hot,  bitter,  yellow-coloured bile,
which being difcharged, feems to afford fome relief, but is quickly
followed by the  fame violent pain as before.  As the diftemper ad-
vances, the propenSity  to vomit^ fometimes increaSes, So as to be-
come almoft continual, and the proper motion oS the inteftines is
So Sar perverted, that there are all the Symptoms oS an impending
iliac paffion.
   IS the patient be young and ftrong, and the pulSe Sull and fre-
quent,  it will be proper to bleed.  ASter which give Sorty drops
oS laudanum,  and adminifter  clyfters to  open  the bowels.—
Clear whey or  gruel,  fharpened with the  juice oS lemon, or
cream oS tartar, muft be drank Sreely. Small chicken broth, with
alittle manna diffolved in it, or a flight decoction of tamarinds,
are likewife very proper, or any other thin, acid, opening liquor.
   Befides bleeding and plentiful dilution, it will be neceffary to
foment  the belly  with cloths dipped in warm water; and if this
fliould not fucceed, the patient muft be immerfed up to t]ie breaft
in warm water „                           n
   In the bilious colic, the  vomiting is often very difficult to re-
flrain.  When this happens, the patient may drink a decoction of
toafted bread, or  an infufion of garden-mint  in boiling water.
Should thefe not  have the defired effect, the faline draught,  with
a few  drops  of laudanum in it, may be given, and repeated ac-
cording to the urgency of the fymptoms.  A  fmall quantity of Ve-
nice treacle may be fpread in form of a cataplafm, and applied to
the pit of the ftomach. Clyfters, with a proper quantity of Venice
treacle or liquid laudanum in them,  may likewiSe be Srequently ad-
miniftered.
   Such as are liable to frequent returns of the bilious colic fhould
ufe  flefh fparingly, and  live chiefly upon a light vegetable  diet,
They fhould take frequently a dofe  of cream of tartar with tama-
rinds, or any other cool acid pusge.
   The hyferic colic bears a great refemblance to the bilious.  It is
attended with acute pains about the  region of the ftomach, vomit-
ing, &c.  But what the patient vomits, in this cafe,  is commonly
of a greenifh colour. 1 here is a great finking of the fpirits, with de-
jection of mind and difficulty of breathing, which are the charac-
teriftic fymptoms  of this diforder.  Sometimes it  is accompanied
with the jaundice, but  this generally goes off of its own accord in
3 few days.  .
   in this colic, all  evacuations, as bleeding, purging, vomiting, 
220                OF  THE  COLIC.

   In  this colic, all evacuations, as bleeding, purging, vomiting,
Sec. do hurt.  Every thing that weakens the patient, or finks the
Spirits, is to be avoided.  IS the vomiting fhould prove violent, luke-
warm water, or Small poffet, may be drank to cleanSe the ftomach.
Afterwards  the patient may take  fifteen, twenty, or twenty-five
drops of liquid laudanum in a glafs of cinnamon water. This may
be repeated every ten or twelve hours till the fymptoms abate.
   Th° patient may likewife take, four or five of the foetid pills eve-
ry fix hours, and  dri lk a cup of penny-royal tea after them.  If
afafcetida fhould prove difagreeable, which is Sometimes the caSe,
a tea-SpoonSul oSthe tincture of caftor in a cup oS penny-royal ten,
or thirty or Sorty  drops oS the balfam  of Peru, dropped upon a bit
of Ioaf-fugar,  may be taken in its ftead.  The anti-hylteric plaifter
may alfo be  ufed, which has oSten a good effect  .
   The  nervous colic  prevails among miners,  Smelters of lead,
plumbers, the manufacturers of white lead, &c.  It is very com-
mon in the cyder counties  of England,  and is fuppofed to be oc-
cafioned by the leaden veffels uSed in preparing that liquor. In the
Weft-Indies it is termed the dry belly-ach.
   No diSeaSe of the bowels is more excruciating than this.  Nor is
it foon at an end. I have known it continue eight or ten days with
very little intermiffion, the  body all the while continuing bound in   '
Spite of medicine, yet at length yield, and the  patient recover}-.
It  generally  leaves the patient weak, and i.t'ten. ends m a palfy.
   The general treatment  of this  difeafe is nearly the fame with
that of the iliac paffion, or inflammation of the guts.  The body
is  to be opened by mi'd purgatives given in fmall  dofes, and fre-
quently repeated, and their opeiation mult be affifted by  SoSt oily
clyfters, fomentations,  &e. Caftor-oil is reckoned peculiarly pro-   j
per in this diSeafe.  It may both be mixed with the clyfters and
given by the mouth.
   Barbadoes tar is Said to be an efficacious medicine in this com-
plaint.  It may be taken to the quantity oS two drachms three times   j
a day, or oStencr if the ftomach will bear it. This tar, mixed with
an equal quantity oS ftrong rum, is likewiSe proper Sor rubbing the
Spine, in caSe any tingling, or other Symptoms of a rah/ are Selt.
When the tar cannot be obtained, the back  may  be rubbed with
ftrong Spirits, or a little oil oS nutmegs  or oS roSemary.
   If, the patient remains weak  and languid after this difeaSe, he
muft take exercife on horfeback, and ufe an infufion of the bark in
wine. When the difeafe ends in a palfy, the bath-waters  are ex-
tremely proper.

              *  See Appendix,  AnfJ-hyfteric plaifter.
  f #ls the finoke of touueco thrown into the bowels will often procure
a (ion!, when all other means have failed, an apparatus for this purpofe
ought to be kept by every fur;;^!!. It nmy be purchafed at a fmall ex-
penfe, and will be of fervice in feveral  other c-u'c-,  as the recovery of
,l;H>wneii perfo.is, <:<c. 
     INFLAMMATION OF THE KIDNEYS.      221

  To avoid this kind of colic, people muft fhun all Sour Sruits,
acids, auftere liquors, &c.  ThoSe who work in lead ought never to
goto their buSmeSs Safting, and  their Sood fhould be oily or Sat.
They may take a glaSs oS  Sallad oil, with a little brandy or»rum
every morning, but fhould never take Spirits alone. Liquid aliment
is beft for them ; as  Sat broths,  &c. but low living is bad. They
Should Srequently go a little out oS the tainted air ;  and fiiould ne-
ver Suffer themSelves to be coftive.  In the Weft-Indies, and on the
coaft oS Guinea, it has been found of great uSe, Sor preventing this
colic,  to wear a piece oS flannel round the wailt, and to drir.k an
inSufion of ginger by way of tea.
  Sundry other kinds of this difeafe mir;ht be mentioned,  but too
many diftinctions perplex the reader. Thofe already mentioned are
the moft material, and fhould be attended  to, as their treatment is
very different.  But even perfons who are not in a condition to dif-
tinguifh very accurately in thefe matters,  may be of fervice to pa-
tients in colics of every  kind,  by only obferving  the  following
general rules, viz.  To bathe the feet and  legs in warm water ; to
apply bladders filled with  warm water,or cloths dipped in it, to the
ftomach and bowels ; to make  the patient drink freely of diluting
mucilaginous liquors ; and to give him an emollient clyfter every
two or three hours. Should  theSe not Succeed,  the patient ought
to be immerfed in warm water.
                Inflammation of the Kidney.-:.


   CAUSES.----This diSeaSe may  proceed  from  my of thofe
cauSes which produce an inflammatory fever.  It may likewiSe be
occafioned by wounds or bruifes of the kidneys ; fmall ftones or
gravel lodging  within them; by ftrong  diuretic medicines; as
Spirits oS turpentine, tincture oScantharides, Sec. Violent motion,
as hard riding or walking, eSpecially in hot weather, or whatever
drives the blood too Sorcibly into the kidneys, may occafion  this
malady.  It may proceed from lying too foft, too much on the back,
involuntary contractions, or fpaSms, in the urinary veffels, &c.
   SYMPTOMS.----There is  a fharp pain  about the region of
the kidneys, with fome degree oS Sever, and a ftupor or dull pain
in the thigh oS the affected fide.  The urine is at firft clear, and
afterwards of a reddith colour ; but  in the worft kind of the dif-
eafe, it generally continues p,de, is paffed with difficulty, and com-
monly in Small quantities at a time.  The patient Seels great  un-
eafineSs when he endeavours to walk or Sit upright. He lies with
mo fteaSc on the affected fide, and has generally a nauSea or vomi-
ting, reSembling that in the colic.
  This diSeaSe mav  be dift::itrv.iihed frcm the  colic,  by therein.
                1         <-                    '   1     >. 
           INFLAMMATION OF THE KIDNEYS.

 being feared  farther back, and by the difficulty  of  pafling urine,
 with which it is conftantly attended.
    REGIMEN. ---Every  thing of  a heating or Stimulating na-
 ture is to be avoided.  The Sood muft be thin  and light;  as pa-
 nado, Small broths, with mild vegetables, and the like.  Emollient
 and thin liquors muft  be  plentiSully  drank; as clear whey, or
 balm-tea Sweetened with honey, decoctions of marfh-mallow roots,
 with barley and liquorice, &c.  The patient, notwithftanding the
 vomiting,  muft conftantly keep fipping fmall quantities of theSe
 or other diluting liquors.  Nothing So SaSely and certainly abates
 the inflammation, and expels  the  obftructing caufe, as copious
 dilution.  The patient  muft be kept eaSy,  quiet, and Sree Srom
 col.I, as long as any Symptoms  oS inflammation remain.
    MEDICINE.----Bleeding is generally necefiary, eSpecially at
 the beginning. Ten or  twelve  ounces  may be let from  the arm
* Math a  lancet, and iS the pain and inflammation continue, the ope-
 ration may be repeated in twenty-Sour hours, efpecially iS the pa-
 tient be ol a  full habit.   Leeches may be applied to  the fnemor-    j
 rhoidal veins, as  a diScharge Srom thefe will greatly relieve  the pa-
 tient.
    Cloths dipped  in warm water, or bladders filled with it, mult be
 noplied as near as poflible to the part affected, and renewed  as they
 grow cool. If the bladders be filled  with a decoction oS mallows
 arid camomile flowers, to which a little Saffron is added, and mix-
 ed with about a third part of new milk, it will be ftill more bene
 facial.*
    Emollient clyfters outfit frequently to be administered ; and if    i
 thefe do not open the body, a little fait and honey or manna may    J
 be added to them.                                                ™
    The fame  courfe is  to  be followed where  gravel  or ftone  is
 lodged in  the kidney, but when the gravel or  ftone is  feparated > •
 from the kidney, and lodges in the ureter,-]-  it will  be proper, be-
 fides the fomentations, to rub the fmall of the back with fweet oil,
 and to  give gentle diuretics ; as juniper-water, fweetencd with the    :
 fyrup of marfh-mallows : a tea-Spoonful of the fweet fpirits of ni-
 tre, with filteen or twenty drops  of laudanum, may be given eve-
 ry three or four  hours until the pain is riiitigated, in a cup of the
 patient's drink.  He ought  kkewife  to tike exercife on horfeback,
 or m a  carriage, if he be able to bear it.
    When the difeafe is protracted beyond the  feventh or eighth
 day, and the patient complains of a ftupor and heavinefs of the  ■  ,
 part, has frequent returns of chillnefs, fhivering, &c. there is rea-   i

    * The patient may go into the warnrbat'i, which is more efficacious.

    t The ureters are two lorvi aiul C;rv.y. canals, one on each fide, which
 carry tbe urim from the i^afon ot the kidneys to the bladder. Tlv-y are
 ibnietimes oijitrncted by  in,all Hones or gravel  faliu^ down from til*
 kuiue}s a;:ci h>u^-n:>; in them.                              » 
      INFLAMMATION OF THE BLADDER.     22 ]

fon to fufpect that matter is forming in the kidney, and that an
abfeefs will enfue.
   When matter in the urine fhows that an ulcer is already form-
ed in the kidney, the patient muft be careful to abftain from all
acrid, four, and  falted provifions ; and  to live chiefly upon  mild
mucilaginous herbs and fruits, together with the broth of young
animals, made with barley and common pot-herbs, &c. His drink
may  be whey, and butter-milk that is  not four.  The latter is by
fome reckoned a fpecific remedy in ulcers of the kidneys.   To an-
fwer this character, however, it mult be drank for a confiderable
time. Chalybeate waters have likewife been found beneficial in thi.i
difeafe. This medicine is eafiiy obtained, as it is found in every
part of Britain. It muft likewife be ufed for a conliderable  time,
in order to produce any Salutary effects.
   Thofe liable to frequent returns of inflammation, or obstructions
of the kidneys, muft abftain from wines, efpecially fuch as abound  .
with tartar; and their food ought to be light, and of eafy digeftion.
They fhould ufe moderate  exercife,  and fhould  not lie too hat,
nor too much on their back.
                Inflammation cf the Bladder.

   The inflammation of the bladder proceeds, in a great meafure,
from the fame caufes as that of the kidneys.   It is known by an
acute pain towards the bottom of the  belly*, and  difficulty of
paffing  urine, with fome cfegree of fever, a conftant inclination
to go to ftool, and a perpetual defire to make water.
   This diSeaSe muft be treated on the Same principles as the  pre-
ceding.  The diet  muft be light,  and  thin, and the drink  of a
cooling nature.  Bleeding is very proper at the beginning, and in
robuft constitutions, it will often  be neceffary  to repeat it.   The
lower part of the belly fhould  be,fomented with warm water, or
a decoction of mild vegetables; and emollient clyfters ought fre-
quently to be adminiftered, Sec.
   The patient fhould abftain from every thing  that is  of a  hot,
acrid, and ftimulating quality,  and fhould live entirely upon fmall
broths,  gruels,  or mild vegetables.
   A ftoppage of urine may proceed from  other caufes befides an
inflammation of the bladder;  as a fwelling of the hemorrhoidal
veins, hard feces lodged in the reclum; a  ftone in the bladder;
cxcrefcences in the  urinary pafluges, a pally of the bladder, hy-
fteric affections, &c  Each of thefe requires  a particular treat-
ment, which does not fall under our prefent confidcratioii; in all

  * A violent pain in the Iswer part of the back is a common fyinpto;^
in  this difeafe. 
o24      INFLAMMATION  OF  THE  LIVER.

oTthem, mild and gentle applications are the fafeft, as ftrong di-
uretic medicines,  or things of an irritating nature,  generally in-
creafe the danger.  Some perfons kill themfelves by introducing
probes into the urinary paffages, to remove, as they think,  Some-
what obstructing  the difeharge of urine, and others bring on  a
violent inflammation of the bladder, by ufing'ftrong diuretics, as
oil oS turpentine, &c. for that purpofe.
                 Inflammation of the Liver.

  THE liver is lefs fubject to inflammation than moft of the other
viSeera, as in it the circulation is flower; but when an inflamma-
tion does happen, it is with difficulty removed, and often ends in
a fuppuration or fchirrus.
  CAUSES.----Befides the common cauSesof inflammation, are
the following, viz. exceffive fatnefs,  a fchirrus of the liver itfelf,
violent Shocks from ftrong vomits when the  liver was before un-
found, any  thing that fuddenly cools the  liver after it has been
greatly heated, ftones obstructing the courfe of the bile, drinking
ftrong wines and fpirituuus liquors, ufing hot fpicy aliment, ob-
flinate hypochondriacal affections, &c.
   SYMPTOMS.---This diSeaSe is  known by  a painful tenfion
of  the right Side under the falfe ribs,  attended with fome degree
oS  Sever,  a  Senfe of  Weight,  or fulnefs of the part,  difficulty of
breathing, loathing of food,  great thirft, with a pale or yellowifh
colour of the fkin and eyes.
   The fpmptoms are various, according to the  degree of inflam-
mation, and to the particular part of the liver where the inflam-
mation happens.  Sometimes the pain is fo inconsiderable, that
an inflammation is not SuSpected; but when it happens  in  the
 upper or convex part oS the liver,  the pain is  more acute,  the
pulfe quicker, and the patient is oSten troubled with a dry cough,
a hiccup, and a pain extending to the fhoulder,  with difficulty of
 lying on the leSt fide,  &c.
    This diSeaSe may be diftinguifhed from the pleurify by the pain
 being lefs violent, feated  under the falfe ribs,  the  pulSe not So
 hard, and by the difficulty of  lying on the left  fide."  It  may be
 diftinguifhed from the hyfteric and  hypochondriac diforders by
 the degree  oS  Sever  with which it is always attended.
    This diSeaSe, if properly treated, is Seldom mortal.  A conftant
 hiccuping,  violent Sever, and exceffive thirft, are  bad Symptoms.^
 If it end: in a fuppuration,  and the  matter cannot be difcharged
 outwardly,  the danger is great.   When the fchirrus of the liver
 enfues, the patient, if he obferves a proper regimen, .may never-
  •\cieis live  *  number of years tolerably eafy; but if he  indulge  - 
INFLAMMATION  OF  THE  LIVER.
 in animal food and ftrong liquors, or take medicines of an  acrid
 or irritating nature, the fchirrus will be converted into a  cancer,
 which muft infallibly prove fatal.
   REGIMEN.----The regimen is in this as in other inflamma-
 tory diforders.  All hot things are to be carefully avoided, and
 cool diluting liquors,  as  whey, barley-water, &c. drank freely.
 The food muft be light  and thin, and the body,  as well as the
 mind, kept eafy and quiet.
   MEDICINE.----Bleeding is proper  at the beginning of this
 diSeaSe, and will oSten be neceffary, even though the pulfe fhould
 not feel hard, to repeat it.  Ail violent purgatives are to be  avoi-
 ded ; the body however muft be kept gently open.  A decoction of
 tamarinds, with a little honey or manna, will anSwer this purpofe
 very well.  The fide affected muft be fomented in the manner di-
 rected in the foregoing  difeafes.  Mild laxative clyfters fhould be
 frequently adminiftered; and, iS the pain fhould ftill continue vi-
 olent, a blifter may be applied over the part affected.*
   Medicines which promote the fecretion of urine have a good ef-
 fect.  For this purpofe, half a drachm of purified nitre, or a tea-
 fpoonful of the fweet fpirits of nitre, may be taken in a cup of the
 patient's drink three or four times a-day.
   When there is an inclination to fweat, it ought to be  promoted,
 but not by warm fudorifics.  The only thing to be ufed for  that
 purpofe, is plenty  of  diluting liquors drank about  the  warmth o£
 the human blood.  The patient in jhis cafe, as well as in all other
 topical inflammations, ought to drink nothing that is colder than
 the blood.
  If the ftools fhould be loofe,  and even Streaked with blood, no
 means muft be uSed to flop them, unleSs they be So Srequent  as to
 weaken the patient. LooSe flools often prove critical, and carry off
 the difeafe.
   If an abfeefs or  impofthume is formed in the liver, all methods
 fhould be tried to  make it break and difeharge itfelf outwardly, as
 fomentations, the  application of emollient poultices, fuch  as are
 made  of bread and  milk, or flaxfeed  flour.   Sometimes  the
 matter of  an abfeefs  comes away in the urine, and  Sometimes
 it is  discharged by ftool, but theSe are efforts of Nature which no
 means can promote.  When the abfeefs  burfts into the cavity of

  * The  moft judicious praftice in this difeafe, is, that which was firft
 employed in the Fad-ladies and China, where inflammations of the liver
 are almoft as prevalent as intermittent fevers are in this country.  After
 moderate evacuations, by bleeding and purging, or frequently without
 the ufe of either, they charge the fydem with mercury as foon as  pof-
fible,  by  rubbing two or three drachms of  mercurial ointment on the
 internal parts of the legs and thighs every morning and evening;  like-
 wife on the  right fide of the abdomen, a little below the pained  part.
This mult be continued until the gums are affected, and repeated  until
the fymptoms difappear. This praaice I have known  frequently fue«
ceed at Canton in China, and likewife in America.    0>^*)
                             F a 
226           CHOLERA MORBUS, &c.

the abdomen at large, death  muft enfue; nor  will the  event be
more Sovourable when the abSceSs is opened by an incifion, unlefs
in cafes where the liver adheres to the peritoneum,* fo as to form a
bag for the matter,  and prevent it from falling into  the cavity of
the abdomen ; in which cafe, opening the abfeefs by  a fufficiently
large incifion, will probably lave  the patient's  life.f
  If  the  diforder Should end in a Schirrus, the patient muft be
careful to regulate his  diet, cVc. in fuch a manner as  not to aggra-
vate the difeafe  He muft not  indulge in flefh,  fifh, ftrong liquors,
or any highly feafoned or falted provisions; but  fhould, for the moft
part, live on mild vegetables,  as  fruits  and roots ; taking  gentle
exercife, and drinking whey, barley-water,  or buttermilk. If he
takes any thing Stronger, it fhould be fine  mild ale,  which is leSs
heating than wines or Spirits.
  We fhall take no notice oS inflammations of the other viScera.
They muft in general be treated upon the Same principles as thoSe
already mentioned. The chieS rule  with refpect to all of them is,
to let blood, to avoid every  thing that is ftrong, or of a heating
nature, to apply warm fomentations to  the part affected,  and to
caufe the patient to drink a fufficient quantity  of warm diluting li-
quors.
              CHAP  T E R   XXXIII.


Of the Cholera Morbus, and other exceffive Difcharges from
                  the Stomach and Bowels.

     THE cholera morbus  is a violent purging and  vomiting,  at-
      tended with gripes, ficknefs, and a conftant defire to go to
flool.  It comes on fuddenly, and is moft  common in autumn.
Hardly any difeafe kills more quickly than this, when proper means
are not ufed in due time for removing  it.

  * When we have reafons to fufpecl that the convex furface of the li-
verdoesnot adhere to the peritonaeum of the abdomen, an incifion fliould
be made in the moft depending part, but not quite through the abdomi-
nal mufcles,in order to excite inflammation in the peritoneum, and pro-
duce adhefion.  This practice  takes off the refiftante,  and  allows the  jJ
fack  of matter to peefs againd the molt yielding part of the peritonaeum,  ■
which is in the dire£tion of the wound, fo that when the  abfeefs burfts,it  ■
difcharges itfelf by the incifion. During the difeharge of the matter,  if ■
the patient's ftrength is much  on the decline,  it muft be fupported by  I
cordials and tonic medicine, together with a fmall allowance of animal
food, fuch as beef-fteaks,  &c.       (I. C.)

  t I know a gentleman who has had feveral abfcelTes of the liver open-
ed, and is now a ftrong and healthy man,  though above eighty years  of
age. 
CHOLERA MORBUS, &c.
227
   CAUSES.----It is occafioned by a redundancy and putrid acri-
 mony of the bile ; cold ; food that eafily turns rancid or Sour on
 the Stomach ; as butter, bacon,  Sweet-meats, cucumbers, melons,
 cherries,  and  other  cold  Sruits.*  It is Sometimes the effect of
 llrong acrid purges or vomits, or of poifonous fubftances taken
 into the ftomach. It may likewife proceed from violent  paffions or
 affections oS the mind ; as Sear, anger,  &c.
   SYMPTOMS.----It is generally preceded by a cardialgia, or
 heart-bum, Sour belchings, and flatulencies, with pain oS the fto-
 mach and inteftines.  To theSe Succeed exceffive vomiting,  and
 purging oS green, yellow, or blackifh coloured bile, with a diften-
 fion of the ftomach, and violent griping pains.  There  is likewife
 a great thirft, with a very quick unequal pulfe, and often a fixed
 acute pain about the region of the navel. As the difeafe advances,
 the pulfe  often finks fo low as to become quite imperceptible, the
 extremities grow cold, or cramped, and are often covered with a
 clammy fweat, the urine is obstructed, and there  is  a  palpitation
 of the heart. Violent hiccuping, fainting, and convulfions, are the
 figns of approaching death.
   MEDICINE.----At the beginning of this difeafe, the efforts of
 Nature to expel the offending caufe fhould be affifted,by promoting
 the purging and vomiting. For this purpofe,  the patient muft drink
 freely oS diluting liquors; as whey, butter-milk, warm water, thin
 water-gruel, Small poffet, or, what is perhaps preSerable to any of
 them, very weak chicken broth.  This fhould  not onJy be drank
 plentifully to promote the vomiting, but a clyfter of it given every
 hour to promote the purging.
   After thefe evacuations have been continued for fome time, a de-
 coction of toafted oat-bread may  be drank to flop the  vomiting.
 The bread fhould be toafted till it is oS a browa colour, and af-
 terwards boiled in fpring water.  If oat-bread cannot be had, wheat-
 bread, or oat-meal well toafted, may be ufed in its ftead. If this
 does not put a Stop to the vomiting, two table-fpoonfuls ofthe faline
 julep, with ten drops of laudanum, may be taken every  hour till it
 ceafes.
   The vomiting and purging ought never to be ftopped too foon.
 As long as thefe difcharges do not weaken the patient, they are falu-
 tary, and may be allowed to go on, or rather ought to be promoted.
 But  when the patient is weakened by the evacuations, which may
 be known from the finking of his  pulfe, &c. recourfe muft imme-
 diately be had to opiates, as  recommended above; to which may
 be added  llrong wines, with fpirituous cinnamon-waters,  and
 other generous cordials. Warm negus,  or ftrong wine-whey,  will
likewiSe be necefiary to Support the patient's Spirits, and promote
 the perSpiration.  His legs fhould  be bathed in warm water,  and

    I have been twice brought  to the gates of death by this difeafo,
and both times it was occafioned by eating  rancid baton. 
S28       DIARRHOEA, OR LOOSENESS.

afterwards nibbed with flannel clotli6, or wrapped in warm blan-
kets, and warm bricks applied to  the  foles of  his feet. Flannels
wrung out of warm fpirituous fomentations fliould likewiSe be ap-
plied to the region of the ftomach.*
  When the violence of the difeafe is over, to prevent a relapfe,
it will be neceffary for fome time to continue the ufe of fmall do-
fes of laudanum.  Ten or twelve drops may be taken in a glafs of
wine,  at leaft  twice a day, for eight or ten  days.  The patient's
food ought to be nourifhing, but taken in fmall quantities, and he
fliould ufe moderate exercife.  As  the ftomach and inteftines are
generally much weakened, an infufion of the bark, or other bit-
ters, in fmall wine, fharpened  with the elixir vitriol, may be drank
for fome time.
  Though phyficians are feldom called in due time in this difeafe,
they ought not todefpair of relieving the patient even in the  moft
defperate circumftances. Of this, I lately faw a very ftriking proof
in an old man and his  fon, who had been both feized with it a-
bout the middle of the night. I did not fee them till next morning,
when they had much more the appearance of dead than of living
men. No pulfe could be felt; the extremities were cold and rigid;
the  countenance was ghaftly, and the ftrength almoft quite ex-
haufled. Yet, from this deplorable condition, they were both  reco-
vered by the ufe of opiates and cordial medicines.
                Of a Diarrhoea, or Loofenefs.

  A LOOSENESS, in many cafes, is not to be confidered as a dif-
eafe, but rather as a falutary evacuation. It ought therefore never to  •
be ftopped, unlefs when it continues too long, or evidently weaken*
the patient.  As this fometimes happens, we fhall point out the
moft  common  caufes of a loofenefs, with  the  proper method of
treatment.
  When a loofenefs is occafioned by catching cold,  or an obftruc-
ted perfpiration, the patient ought to keep warm, to drink freely
©f weak diluting liquors, to bathe his feet  and legs in lukewarm
water, to wear flannel next his fkin, and to take every other me-
thod to reftore the perfpiration.
  In a loofenefs which proceeds from excefs or repletion, a vomit
is the proper medicine.  Vomits not only cleanfe the ftomach, but
promote  all the fecretions, which render  them of great impor-
tance in carrying off a debauch. Half a drachm of ipecacuanha in
powder will anfwer this purpofe very well.  A day or two after
the vomit, the fame quantity of rhubarb may betaken, andrepear
  * Should the vomiting continue obflinate, a blifter or poultice compo-
fed of rye meal, flower of muftard, and vinegar, applied to theregioa
pf the ftomach, and continued until it gives pain, or even forms a blif
t«r, is frequently attended with the beft effefts.     (I. C.) 
           DIARRHOEA,  OR LOOSENESS.       229

ted two or three  times, if the JoofeneSs continues.  The patient
ought to live upon light vegetable Sood, of eafy  digeftion, and to
drink whey, thin gruel, or barley-water.
   A loofenefs occafioned by the obstruction oS any cuftomary eva-
cuation, generally requires bleeding. If that does not Succeed, other
evacuations may  be  Subftituted in the room  oS thoSe  which are
obstructed.   Ar the Same time, every method is  to be taken to re-
ftore the ufual difcharges,  as not only the cure of the difeafe, but
the patient's life,  iruy depend on this.
   A periodical  loofenefs ought never to be Stopped.  It is always
an effort oS Nature to carry off Some offending matter, which,  if
retained in the  body, might have fatal effects. Children are very
liable to  this kind of loofenefs, efpecially while teething.  It is,
however, fo far from being hurtful  to them, that fuch children
generally get their teeth with leaft trouble.  If  thefe loofe Stools
Should at any time prove four or griping, a tea-fpoonful of  mag-
nefia alba, with four or five grains of rhubarb, may be given to the
child  in a little  panado, or any other food. 1 his, if repeated  three
or four times, will generally correct the acidity, and carry off the
griping ftools.
   A loofenefs which proceeds from violent paffions or affections
of the mind, muft be treated with the greateft caution. Vomits
in thi6 cafe are highly improper. Nor are purges fafe, unlefs they
be very mild, and given in fmall quantities.   Opiates,  and other
antifpafmodic medicines are moft proper. Ten or twelve drops of
laudanum may  be taken in a cup of valerian  or penny-royal tea,
every eight or ten hours, till  the fymptoms abate. Eafe, cheerful-
nsfs and tranquillity of mind, are here of the greateft importance.
   When a loofenefs proceeds from acrid or poifonous  fubftances,
taken into  the  ftomach, the patient muft drink large  quantities
of diluting liquors, with oil or fat broths, to promote vomiting
and purging.  Afterwards,  if there be reafon to fufpect that the
bowels are inflamed, bleeding will be neceffary. Small dofes of
laudanum may likewife be taken to remove their irritation.
   When the gout, repelled from the extremities, occafions a loofe-
nefs, it ought to be promoted by gentle dofes of rhubarb, or  other
mild  purgatives.  The gouty matter is likewife to be Solicited to-
wards the extremities by warm fomentations, cataplafms,&c. The
perfpiration ought at the fame time to be promoted by warm di-
luting liquors ; as wine-whey, with fpirits of hartfliorn, or a few
drops of laudanum in it.
   When a loofenefs proceeds from worms, which may be known
from  the fliminefs  cf the ftools,  mixed with pieces of decayed!
worms, &c.  medicines muft be given to kill and carry off thefe
vermin, as the powder of tin, with purges of rhubarb and calomel.
Afterwards lime-water, either alone, or  with a fmall  quantity  of
rhubarb  infufed, will be proper to ftrengthen the bowels, and prer
vent the new generation of worms. 
S3®
VOMITING.
   A loofenefs is often occafioned by drinking bad water.   When
this  is the  cafe, the difeafe generally proves epidemical.  When
there is reafon to believe that this,  or any other difeafe proceeds
from the ufe of unwholefome water, it ought immediately to be
changed, or if that cannot be done, it may be corrected by mixing
with it quick-lime,  chalk, or the like.
   In people, whofe ftomachs are weak, violent exercife immedi-
ately after  eating, will occafion a loofenefs.  The cure of this is
obvious; yet it will be proper, befides avoiding violent exercife, to
ufe fuch medicines as tend to brace and Strengthen the  ftomach,
as inSufions of the  bark, with other bitter and aftringent ingredi-
ents, in white  wine. Such perfons ought likewife to take frequent-
ly a glafs or two of old red port, or good claret. *
  From whatever caufe a loofenefs proceeds, when it is found ne-
ceffary to check it, the diet ought to confift of rice boiled with
milk, and flavoured with  cinnamon ; rice-jelly;  fago, with red
port; and the lighter forts of flefh-meat roafted.  The drink may
be thin  water-gruel, rice-water,  or weak broth, made from lean
veal, or with  a fheep's head, as being  more gelatinous than mut-
ton,  beef, or chicken-broth.
  Perfons, who  from a peculiar weaknefs, or too great an irrita-
bility of the bowels, are liable to frequent returns of this difeafe,
Should live temperately,  avoiding  crude  fummer fruits, all un-  ,
wholefome food, and meats of hard digeftion. They ought like-
wife to beware of cold, moifture, or  whatever may obstruct the
perSpiration, and fhould wear flannel next their fkin.  All violent
paffions,  as Sear, anger, &c. are  careful J y to  be guarded againlt.
                        Of Vomiting.
  VOMITING may proceed from various caufes;  as excefs in
eating and drinking 5 foulnefs of the ftomach ;  the  acrimony of
the aliments; a tranflation of the morbific matter of ulcers, of the
gout, the eryfipelas, or other difeafes, to the ftomach. It may like-
wife proceed from a loofenefs having been too fuddenly ftopped ;
from the 'ftoppage of any cuftomary evacuation, as  the bleeding  (
piles, the menfes, &c from a weaknefs of the ftomach,  the colic,
the iliac paffion, a rupture, a fit of the gravel,  worms; or Srom  j
any kind oS poiSon taken into the ftomach. It is an uSual Symptom
of injuries done to the brain ; as contufions, compreffions, &c. It
is likewife  a  fymptom of wounds  or infldmmations of the  dia-
phragm, inteftines, fpleen,  liver,  kidneys, &c.
  Vomiting may be  occafioned by unufual motions ;  as  Sailing,  [
being drawn hackwards in a cart or coach, &c. by violent paffions,

  *  After every aflringent and tonic  medicine has failed in the chronic  =
diarrhoea of warm climates, a long voyage to fea has entirely removed
the complaint.        (I. C) 
VOMITING.                    231
or by the idea of naufeous or difagreeable objects, eSpecially of
Such things as have Soimerly produced vomiting.  Sometimes it
proceeds Srom  a regurgitation oS the bile into the ftomach : in
this caSe, what  the patient vomits,  is generally of  a  yellow or
prreenifh colour, and has a bitter tafte.  Perfons who are fubject to
nervous affections, are often fuddenly feized with violent fits of
vomiting.  Laftly, vomiting is  a  common fymptom of pregnancy.
In this cafe, it generally comes on about two weeks after the ftop-
page of the menfes, and continues during the firft three or four
months.
  When vomiting proceeds from a foul ftomach or indigeftion,
it is not a difeafe, but the cure of a difeafe.  It ought therefore
to be promoted by drinking lukewarm water, or thin gruel. If this
does not put a flop to the vomiting, a dofe of ipecacuanha may
be taken, and worked off with weak camomile tea.
   When the retroceffion of the gout, or the obftruction of cufto-
mary evacuations, occafion vomiting, all means muft be ufed to re-
ftore thefe difcharges ; or, if that cannot be effected, their place
muft be fupplied by others, as bleeding, purging, bathing the extre-
mities in warm water, opening iffues, fetons, perpetual blifters, &c.
   When vomiting is the effect of pregnancy,  it may generally be
mitigated by bleeding, and keeping the body  gently open.  The
bleeding however ought to be in fmall quantities at a time, and
the purgatives fhould be of the mildeft kind, as figs, ftewed prunes,
manna, or fenna.  Pregnant women are moft apt to  vomit in the
morning,  immediately after  getting out of bed,  which is owing
partly to the change of pofture, but more to the emptinefs of the
ftomach.  Ic may generally be prevented by taking a difh of coffee,
tea,  or fome light breakfaft in bed.  Pregnant women who are af-
flicted with vomiting, ought to  be kept eafy both  in body and
mind.  They fhould neither allow their ftomachs to be quite emp-
ty, nor fhould they eat muchat once.  Cold water is a very proper
drink in this cafe ; if the ftomach be weak, a little brandy may be
added to it.  If the fpirits are low, and the perfon apt to faint, a
fpoonful of cinnamon water, with a little marmalade of quinces
or oranges maybe taken.
   If vomiting  proceeds from weaknefs of the ftomach, bitters
will be of fervice. Bark infufed in wine or brandy, with  as much
rhubarb as will keep the body gently open, is an excellent medi-
cine in this cafe. The elixir of vitriol is alfo good.  It may be
taken in the dofe of fifteen or twenty drops, twice or thrice a-day,
in a glafs of wine or water. Habitual vomitings are fometimes alle-
viated by making oy Iters a principal part of diet.
   A vomiting, which proceeds from acidities in the Stomach,  is
relieved by alkaline purges. The beft medicine ©f this kind is the-
magnefia alba, a tea-Spoonful of which may be taken in a difh off
tea or a little milk, three or four times a day, or oftener if necefhV
ry, to keep the body open. 
 232                  DIABETES,  tsfe.

   When vomiting proceeds from violent paSfions, or affections of
 the mind, all  evacuations muft be carefully avoided, efpecially
 vomits. TheSe are exceedingly  dangerous. The patient,  in  this
 caSe, ought to be kept perfectly eafy and quiet, to have the mind
 foothed, and to take fome gentle cordial, as negus, or a little
brandy and water, to which a few drops of laudanum may oc-
 cafionally be added.
   When vomiting proceeds from fpafmodic affections of the fto-
 mach, mufk, caftor, and other antiSpaSmodic medicines, are of
 uSe.  Warm and  aromatic plafters have  likewiSe a good effect.
 The ftomach-plafter oS the London  or  Edinburgh  diSpenSatory
 may be applied to the pit oS the ftomach, or a platter of theriaca,
 which will anfwer rather better.  Aromatic  medicines  may be
 taken  inwardly, as cinnamon or  mint-tea, wine  with fpiceries
 boiled in it, &c.  The region of the ftomach may be rubbed with
 aether, or,  if that cannot be had,  with ftrong brandy, or other
 fpirits.  The belly fhould be fomented with warm water, or  the
 patient immerfed up to the breaft in a warm bath.
   The faline  draughts taken in the act of effervefeence are of
 Singular ufe in flopping a vomiting, from whatever caufe.  Thefe
 may be prepared by diffolving a drachm of the fait of  tartar in an
 ounce and half of frefh lemon juice, and  adding to  it an ounce
 of peppermint-water, the fame quantity  of fimple cinnamon-
 water, and a little white fugar.  This draught muft be fwallowed
 before the effervefeence is quite over, and  may be repeated every
 two hours, or oftener, if the vomiting be violent.  A violent vo-
 miting has  fometimes been ftopped by cupping on the region of
.the ftomach after all other means had failed.
   As  the leaft motion will often bring on the vomiting again,
 even after it has been ftopped, the patient muft avoid all manner
 of action.  The diet muft be fo regulated as to fit eafy upon the
 ftomach, and  nothing fhould be taken that is hard of digeftion.
 The patient fhould not live entirely upon flops.  Solid food, in this
 cafe,  often fits eafier on the ftomach than liquids.
             CHAPTER   XXXIV.

Of the Diabetes, and other Diforders of the Kidneys  and
                          Bladder.

     THE diabetes is a frequent and exceffive difeharge of urine.
      It is rare among young people ; but often attacks perfons in
the decline of life, efpecially thofe who follow the more violent
employments, or have been hard drinkers in their youth.
  CAUSES----A diabetes is often the confequence  of acute
difeafes, as fevers, fluxes, &c. where the patient has Suffered by 
               OF  A DIABETES, Iffc.,            J233

exceffive evacuations, or by great fatigue,  as riding long journies
upon a hard trotting horfe, carrying heavy burdens, running, &c.
It may be brought on by  hard  drinking, or the ufe of ftrong fti-
mulating diuretic medicines,  as tincture of cantharides, fpirits of
turpentine,  and fuch-like,  or by drinking too great quantities of
mineral waters. Many imagine that thefe will do them no fervice,
unlefs  they be drank in great quantities, by which they often occa-
fion worfe difeafes  than thofe they intended  to cure.   This dif-
eafe may proceed from too great a laxity of the organs which fe-
crete the urine, from fomething that ftimulates the kidneys too
much, or from a thin diffolved flale of'the blood, which makes too
great a quantity of it run  off by the urinary paffages.
 3 SYMPTOMS.----In a diabetes, the urine generally exceeds
in quantity  all the liquid food which the patient takes.  It  is thin
and pale, of a fweetifh  tafte, and an agreeable fmell. The  patient
has a continual thirft, with fome degree of fever ; his mouth is dry,
and he fpits frequently a frothy Spittle.  The ftrength fails, the
appetite decays, and the flefh waftes away till the patient is redu-
eed to fkin and bone. There is a heat of the bowels ; and frequent-
 ly the loins, tefticles, and feet are fwelled.
   This difeafe may generally be cured at the beginning ; but after
 it has  continued long,  the curt becomes very difficult.  In drun-
 kards  and very old people, a perfect cure is not to be expected.
   REGIMEN.----Every thing that ftimulates the urinary paffa-
 ges, or tends to relax the habit, muft be avoided.  For this reafon,
 the patient  fhould live, chiefly on folid food. His  thirft may be
 quenched with acids; as  forrel, juice of lemon, or vinegar.  The
 mucilaginous vegetables,  as rice,  fago, and falop, with milk, are
 the molt proper food.  Of animal fubftances, fhell-fifh are to bs
 preferred ;  as oyfters, crabs, &c. The drink may be Bristol-water.
 When that cannot be obtained, lime-water,  in which a due pro-
  portion of  oak-bark has been macerated, may be uSed. The white
 decoction*, with ifinglaSs diffolved in it, is a very proper drink.
    The patient ought daily to take exercife, but it mould be fo gen-
  tle as  not to fatigue him.  He fhould lie upon a hard bed or ma-
  trtifs.  Nothing hurts the kidnies more than iying too foSt. A warm,
  dry air, the fleSh-bruSh, and every, thing that promotes perSpira-
  tion,  is of  fervice. For this reafon, the patient ought to wear flan-
  nel next his fkin.   A lar^e Strengthening plaifter may be applied
  to the back ; or, what will anSwer better, a great part oS the body
  may be wrapt in plaifter.
    MEDICINE.----Gentle purges, if the patient be not too much
  weakened  by the difeafe, have a good effea. They may confift of
  rhubarb, with cardamum feeds, or any other fpiceries, mSufed in
  wine, and  may be taken in Such quantity as  to keep the body gen-
  tly open.

               * See Ap?,L-adix, White Deception.
                             G 2 
234
SUPPRESSION OF URINE.
  The patient muft next have recourfe to aftringents  and corro-
borants.  Half a drachm of powder, made of equal parts of allum
and the infpiffated juice commonly called Terra Japonica,  may be
taken four times a-day, or oftener, if the ftomach will bear it. The
allum muft firft be  melted in a crucible ; afterwards they may
both be pounded together.  Along with every dofe  of this pow-
der, the patient may take a tea-cupful of the tincture of rofes*.
  If the patient's ftomach  cannot bear the  allum  in Subftance,
whey may  be made oS it, and taken in the doSe oS a tea-cupful
three or four times a day. The allum-whey is prepared by boiling
two Englifh quarts of milk over a flow fire, with three drachms of
allum, till the curd feparates.
  Opiates are of fervice in  this difeafe,  even  though the patient
refts well. They take offfpafm and irritation, and at the fame time
leffen the  force of the circulation.  Tenor twelve  drops of lauda-
num  may be taken in a cup of the patient's  drink three  or four
times a-day.
  The beft corroborants which we know, are the bark and wine.
A drachm of bark may be  taken in a glafs of red port or claret,
three  times a-day. The medicine will be both more efficacious and
lefs difagreeable, if  fifteen  or  twenty drops of  the  acid elixir of
vitriol be added  to  each dofe.  Sifth as cannot take  the bark in
fubftance, may ufe the decoction, mixed with an equal  quantity of
red wine,  and fharpened as above.
  There is a difeafe incident to labouring people in  the decline of
life, called an Incontinency of Urine. But this is very different from
a diabetes, as the water paffes off involuntarily by drops, and does
not exceed the ufual quantity.  1 his difeafe is rather troubleSome
than dangerous.  It is owing  to  n relaxation  oS the Sphincter of
the bladder, and is oSten  the effect oS a palSy.  Sometimes it pro-
ceeds Srom hurts, or injuries occafioned by blows,  bruifes, preter-
natural labours, &c.   Sometimes it is the effect of a fever.   It may
likewife be occafioned by a long ufe of ftrong diuretics. This dif-
eafe may be mitigated by the ufe of aftringent and  corroborating
medicines, fuch as have been mentioned above ; but I  have never
feen it cured.
  In  an incontinency of urine, from whatever caufe, a  piece of
fponge ought to be worn, or a bladder applied in  fuch a  manner
as to prevent the urine from galling and excoriating the parts.
                 Of a  Subprcjfion ^f Urine.

  A SUPPRESSION of urine may proceed from various caufes;
as an inflammation  of  the kidneys, or bladder;  fmall ftones or
gravel lodging in  the urinary paflages, hard  faces lying in the

              * See Appendix, Tincture ci'  R ,Ce$. 
SUPPRESSION  OF URINE.
rectum, pregnancy,  a SpaSm or contraction of the neck of the
•bladder, clotted blood in the bladder itfelf,  a  Swelling of the hse-
morrhoidal veins, &c.
   Some of thefe cafes require  the  catheter, both to remove the
obstructing matter, and to draw off the urine  ; but as this instru-
ment can only be managed with SaSety by perSons Skilled in Surge-
ry, we fhall Say nothing Surther oSits ufe. A bougee may be ufed
by any cautious hand, and will oSten Succeed better than the cathe-
ter*. We chiefly recommend, in all obftrudtions oS urine,fomenta-
tions and evacuants. Bleeding, as Sar as the patient's ftrength will
permit, is  neceffary, eSpecially  where there are Symptoms oS topi-
cal inflammation. Bleeding in this caSe not  only abates the Sever,
by leffening the force of the circulation, but, by relaxing the folids,
it takes off the fpaSm or Stricture upon the veffels which occafion-
ed the obstruction.
   ASter bleeding, Somentations muft be uSed.  TheSe may either
confift oS warm water alone, or oS decoctions oS mild vegetables ;
as mallows^ camomile-flowers,  &c. Cloths dipped in thefe may ei-
ther be applied  to the part affected, or a large  bladder filled with
the decoction may be  kept  continually upon it.  Some  put the
herbs themtelves into  3 flannid bag, and apply them to the  part,
which is Sar Srom being  a bad Vnethod.  TheSe  continue longer
warm than cloths dipped in the decoction,  and at _ the Same time
keep the part equally  moift.
   In all obftrudions  oS  urine, the body ought to be kept open.
This is not however to be attempted by ftrong purgatives, but by
emollient clyfters, or gentle infufions of fenna  and manna.   Clyf-
ters in this caSe  not only open the body, but anSwer the purpole'of
an internal fomentation, and greatly affift in removing the fpafms
of the bladder and parts adjacentf.
   The food muft be light, and taken in fmall quantities. The drink
may be weak broth, or decoctions  and  infufions of mucilaginous
vegetables, as marfh-mallow-rcots or flax-feed.  A tea-Spoonful of
the fweet fpirits of nitre, or a drachm of Caftile foap, may be fre-
quently put  into the patient's  drink.         "
   Perfons Subject to a Suppreffion of urine ought to live very tem-
perate. Their diet fhould be light and their  liquor diluting. They
fliould ayoid all acids and auftere wines, fliould take Sudfeient ex-
erciSe, lie hard,  and avoid ftudy and Sedentary  occupations.

   *■ In cafes of total fupprefTion of urine from ftridtures in the nrethni,
when n-uiK-r of thefe inttruments could be introduced into the bUdder.,
to evacuate the urine, I have fucceeded in two initances out ot tin-  e. by
puncturing the bladder with a long trocar, immediately above ttK pubis,
and evacuating the urine through the canula, until the obfrruction was
removed by the ufe of bougees.    (I. C.)
   t When the bowels have been freely opened, emollient ciyiTer?have
the Uiuit happy efrecf.  Yhefe  fliould be i.ijecK'd every >\ru or three
houi'j, w'.th uuc or two aracinus of laudanum in each.   (I. C.) 
C   nt   ]
                 Of the  Gravel and Stone.

   WHEN Small ftones are lodged in the kidneys, or discharged
alon.rwith the urine, the  patient is  Said to be afflicted  with the
gravel  If one of thefe ftones happens to make  a lodgement in the
bladder for fome  time, it accumulates frefh matter, and at length
becomes too large to pafs off with the urine. In this cafe the patient
is faid to  have the ftone.
   CAUSES.----The ftone and gravel may be occafione\l by high
living ; the uSe oS ftrong aftringent wines ; a Sedentary life ; lying
too hot, foft, or too much on the back ;  the conftant ufe of water
impregnated with earthy or ftony particles ; aliments of an aftrin-
gent or windy nature, &c. It may likewiSe proceed Srom an he-
reditary diSpofition.  PerSons in the decline oS liSe,  and thoSe who
have been much afflicted  with the gout or rheumatiSm,  are moft
liable to it.
   SYMPTOMS.----Small ftones or gravel in the kidneys occa-
fion pain  in the loins ; fickneSs •,  vomiting ; and Sometimes bloody
urine.  When the ftone defcends into the ureter, and is too large to
paSs along with eaSe, all* the abovenfymptoms  are increaSed ; the
pain extends towards the bladder / the thigh and leg of the affected
fide are benumbed ; the tefticles are drawn upwards, and the urine
is  obftructed.
   A Stone in the bladder  is known from a pain, at the time, as
well as before and  after making water ; from the urine coming
away by drops, or flopping fuddenly when it was running in a full
Stream ; by a violent pain in the neck of the bladder upon motion,
eSpecially on horSeback, or in a carriage on a rough road ; Srom
a whire,  thick, copious, ftinking, mucous Sediment in  the urine;
from an itching in the top of the penis ;  from bloody urine; from
an inclination to go to ftool during the difeharge of urine ; from
the patient's paffing his urine more  eafily when lying  chan in an
erect pofture ; Srom a kind of convulfive motion occafioned by the
Sharp pain in discharging the laSt drops oS the urine; and hftly,
from founding or fearching with the catheter.
   REGIMEN.----Perfons afiliaed with the  gravel  or ftone
Should avoid aliments oS a windy or heating nature, as Salt meats,
Sour Sruits,  &c.  Their diet ought chiefly to confift of fuch things
as promote the fecretion cf urine, and keep the body open.  Arti-
chokes,  afparagus, fpinnage, lettuce^ parfley, Succory,  purilane,
turnips, potatoes, carrots,  and radiflies, maybe SaSely eaten. Oni-
ons, leeks, and celery, are, in this caSe, reckoned  medicinal.   The
moft proper drinks are whey, butter-milk, milk and water, barley-
water ; decoctions or  infufions  of the roots  of marfh-mallows,
parfley, liquorice, or oS ether mild mucilaginous vegetables, as lin-
Seed.  If the patient has been accuftomed to generous licucrs, he
may drink fmall gin  punch. 
            THE  GRAVEL  AND STONE.       237

  Gentle exercife is proper ; but violent motion is apt to occasion
bloody urine.  We advife  that  it lhould be taken in moderation.
Perfons afflicted with gravel, often pafs a great number of ftones
after riding on horfeback,  or in a carriage ;  but thofe who have a
Stone in the bladder, are Seldom able to bear thefe kinds oS exerciSe.
Whete there is a hereditary tendency to this diSeaSe, a Sedentc y
life ought never to be indulged. Were people careSul, upon the
firft Symptoms oS gravel, to obServe a proper regimen of diet, . -:d
to take Sufficient exercife,  it might often be carried off,  or at kaft
prevented Srom increafing; but if the fame courfe which occafion-
ed the difeaSe  is perfifted in, it muft be aggravated.
  MEDICINE.----In what is called a hYof the gravel, whkh is
commonly occafioned by  a  ftone Sticking in  the ureter or feme
part of the urinary paffages, the patient muft be bled,  warm  Seg-
mentations fliould likewiSe be applied to the part affected, emolli-
ent anodyne clyfters adminiftered, and  diluting mucilaginous li-
quors drank, &c.  The  treatment oS  this caSehas keen fully point-
ed out under the  articles,  inflammation of the kidnrys and bladder, to
which we refer.
   Dr. Whyte advifes patients, who.are fubject to frequent fits cf
gravel in the kidneys, but have no ftone in the bladder, to drink,
every morning, two or three hours  before breakfaft, an Englifh
pint of oyfter or cockle-fhell lime-water. The Doctor very jullly
obferves, that though this  quantity might be too fmall to have any
fenfible effect in diffolving a Stone in  the bladder, yet it may very
probably prevent its growth.
   When a ftone is formed in the bladder, the Doctor recommends
Alicant foap, and oyfter, or cockle-fhell lime-water,* to be  taken
in the following manner:  The patient muft Swallow, every diy,
in any Sorm that is leaft  diSagreeable,  an ounce oS the internal part
of Alicant foap, and drink three or four Englifh pints of oyfter, cr
cockle-fhell lime-water. The foap is to be  divided into three do-
fes ;  the largeft to be taken fafting in the morning early ; the fe-
cond at noon ; and the third at icven in the evening; drinking,
above each dofe, a large draught of the lime-wrier ; the remainder
of which he may take any time betwixt dinner and fupper, inftead
of other liquors.
   The patient fhouhl-begin with a Smaller quantity of the Ihne-wrt-
ter and Soap, than that mentioned abc.ve ; at firft an Englifh pint
of the former, and three drachms of the latter, may be taken daily.
This quantity, however, he may increafe by degrees, and ought to
perfevcre in  the ufe of thefe medicines, efpecially if he finds any
abatement of his complaint.'-., for. feveral months ; nay, if the ftcne
be very large, Sor years. It may likewiSe be proper Sor the patienr,
iS Severely pained, not only to begin with the Soap and lime-water
in Small  quantities, but  to take the Second  or third  lime-w ..ter in-
* See Appendix,  L'u.e water. 
238        INVOLUNTARY  DISCHARGES

lLead oS the firft.  However, after he has been for fome time ac-
cuiionicd to thefe  medicines, he may not only take the firft water,
but, ii he finds he can eafily bear it, heighten its  diffolving power
ftill more by pouring it a fecond time on frefh calcined Shells.
   The caultie alkali, or Soap lees, is the medicine chiefly in vogue,
at prefent,  Sor the ftone. It is oS a very acrid nature,  and ought,
therefore, to be given in fome gelatinous or mucilaginous liquor;
as veal-broth, new milk, linfeed tea, a Solution of gum-arabic, or a
decoction of  marfh-mallow roots. 1 he patient muft  begin w ith
Small  dofes of the  lees, as thirty or forty drops,  and  increafe by
degrees, as far as the ftomach can  bear it.*
   Though the foap-lees  and lime-water are the moft powerful
medicines which have hitherto been difcovered for the ftone ;yet
there  are fome things  of a more fimple nature,  which in certain
cafes  are found to be beneficial, and therefore deferve a trial.  An
infufion of the feeds of wild carrot, Sweetened with  honey,  has
been found to give confiderable eaSe in caSes where the  ftomach
could not bear any thing oS an  acrid nature.  A decoction' of raw
coffee-berries taken morning and evening, to the  quantity of eight
or ten ounces, with ten drops of fweet fpirit of nitre, has, likewife,
been found very efficacious in bringing away large ■ quantities of
earthy matter in flakes.  Honey is likewife found to be of conli-
derable Service, and may be taken in gruel, or  in any  other Sorm
that is more agreeable.
   The only other medicine which we Shall mention is  the uva urft.
It has been greatly extolled oS  late, both Sor the gravel and ftone.
It Seems, however, to be, in all reSpects, inSerior to the Soap and
lime-water ;  but it is leSs difagreeable, and has Srequently, to my
knowledge, relieved gravelly complaints.   It is generally  taken in
powder from halSa drachm to a whole drachm, two or three times
a-day. It may, however, be taken to the quantity of Seven or eight
drachms a-day, with great fafety and good effect.
               C  II A PIER   XXXV.

          ^  Of involuntary Difcharges of Blood.

   INVOLUNTARY difcharges cf blood often happen from va-
    rious parts of the body.  I'hefe are fo far from being always
dangerous, that they prove often Salutary.  When fuch difcharges
are critical, which 13 frequently the caSe in Severs, they ought not
to be  ii.oppv.d.  NjI is  it proper at any time to flop them, unkfs

  •3f The cauftic r.lk.li maybe prep ired by mixing two parts of quick-
lime wuh out- of j .>ta(hei:, and umering them to itand till the lixivium
be i'or.'U-d,  wau.i  m.tlt be carefully filtr.iu-d before it be tulu.  If the
f... cion does^io,. Ji 'pt._..i re.-u.,}-, afiuaii ijuanuty vi water may be aii
«Jee -o l'.:i: ia..^.:;;. 
                     OF BLOOD.                    239

they he fo great as to endanger the patient's  life.  Moft  people,
afraid of the fmalleft difeharge of blood from any part of the bo-
dy, fly immediately to the ufe of ftyptic and aftringent medicines,
by which means an inflammation of the brain, or fome other fatal
difeafe, is occafioned, which had the diScharge been allowed to go
on, might have been prevented.
   Periodical discharges oS blood, Srom whatever part of the body,
muft not be ftopped.  They are always the  efforts of Nature to
relieve herfelf; and Satal diSeaSeshave oSten been the conSequence
of obstructing  them. It may indeed be Sometimes  neceffary to
check the violence of fuch  dileharges ;  but even this  requires the
greateft caution.  Inftances might  be given where the flopping of
a fmall periodical flux of blood from  one of the fingers, has proved
fatal.
   In the early period of life, bleeding at the nofe is very common.
Thofe who are farther advanced in years, are more liable to hae-
moptoe, or difeharge of blood from the lungs.  After the middle
period of life, ha-'morrhoidal fluxes are  moft common ; and in the
decline of life, difcharges of blood from the urinary  paffages.
   Involuntary fluxes of blood may proceed from very different,
and oSten Srom quite oppofite cauSes.  Sometimes they are owing
to a particular construction of the body, as a fanguine tempera-
ment, a laxity of the veffels, a plethoric  habit, &e. At other times
they proceed from a determination oS the blood towards one par-
ticular part, as the head, die hemorrhoidal veins, &c. They may
proceed Srom an inflammatory diSpofition of the blood, in which
caSe there  is generally Some degree of  fever :  this likewiSe hap-
pens when the flux is occafioned by an  obstructed perSpiration, or
a Stricture upon the fkin, the bowels, or any particular part oS the
Syftem.
   Haemorrhages occur in malignant fevers, dySentery, Scurvy, ma-
lignant Small pox, &c. In theSe difeaSes, there are great discharges
of blood Srom different parts of the body.  They may likewife be
brought on by too liberal a ufs of medicines, fuch as  cantharides,
&c.  Food of an  acrid or irritating quality may occafion haemor-
rhages ; as alfo ftrong purges and vomits, or any thing that greatly
ftimulates the bowels.
   Violent  paffions or agitations of the  mind may have this effect.
Thefe often caufe bleeding at the nofe ;  fometimes awncemorrhage
in the brain. Violent efforts of the  body, by overitraining cr hurt-
ing the veflels, may have the Same effect, efpecially when the body
is long  kept in an  unnatural pofture,  as  hanging the  head very
low, &c
   The cure of an  haemorrhage muft  be  adapted to its caufe.
When it proceeds from too much blood, or a tendency  to inflam-
mation, bleeding, with gentle purges and ether evacuations, will
be neceffary.  It will likewiSe be proper  Sor the patient in this caSe
to  live  chiefly up >:i  a vegetable diet, to  avoid all Strang liqu;:\>, 
24o        OF BLEEDING AT THE NOSE.

and food that is of an acrid, hot or ftimulating quality.  The body
Should be kept cool and the mind eafy.
  When hemorrhage comes on in malignant fevers, feurvy,  &c.
the patient ought to  live chiefly  upon acid fruits with  milk, and
vegetables of a nourifhing nature, as fago, falop, &c.   His drink
may be wine diluted  with water, and fharpened with the juice of
lemon, vinegar, or fpirits of vitriol.  The beft medicine in this cafe
is the  Peruvian bark, which may be taken  according to the urgen.
cy of  the fymptoms.
  When a flux of blood is the effect of acrid food, or of ftrong
Stimulating medicines, the cure is to be effected by foft and mu-
cilaginous diet.  The patient  may likewife take frequently about
the bulk  of a nutmeg of Locatelli's balfam,  or the Same quantity
cf Spermaceti,
  When an obstructed perSpiration, or a ftricture upon any part
of the fyftem, is  the'caufe of an hemorrhage, it may be removed
by drinking warm diluting liquors^lying a-bed, bathing the extre-
mities in warm water, &c.
                  Of Bleeding at the  Nofe.

   THIS is commonly preceded by fome degree of quicknefs of
 the pulfe, flufhing in the face, puliation  of the temporal arteries,
 heavinefs in the head, dimnefs oS the fight, heat and itching oS the
 noftrils, &c.
   To perSons who abound with blood, this diScharge is very Salu-
 tary. It oSten cures a vertigo, the head-ach, a phrenzy, and even
 an epilepfy.  In Severs, wdiere there  is  a great determination of
 blood towards the head, it is of the utmoft Service. It is  beneficial
 Sor inflammations oS the liver and Spleen, and  oSten in the gout
 and rheumatiSm.  In all diSeaSes where  bleeding is necefiary, a Spon-
 taneous diScharge oS blood Srom the noSe is oS  more Service than
 the Same quantity let with a lancet.
   In a  difcbnrge of" blood Srom the noSe, the great point is to de-
 termine wnether it ought  to be  ftopped or not. It  is a common
 practice to  flop the bleeding, without considering  weather it be a
 diSeaSe,or the cure oS a difeafe. This conduct proceeds Srom Sear;
.but it has often bad, and fometimes fatal conSequences.
   When a diScharge of blood Srom the noSe happens in an inflam-
 matory diSeaSe, there is always reafon to  believe that it may prove
 Salutary; and therefore it fhould be Suffered to go on, at leaft as
 long  as the patient is not weakened by it.
   When it happens to perfons in perfect health who are full of
 blood, it ought not to be fuddenly flopped, especially if  the fvinj- 
            OF BLEEDING AT THE NOSE.       241

toms of plethora, mentioned above, have preceded it. In this cafe,
it cannot be flopped without rifking the  patient's life.
  In fine, whenever bleeding at the note relieves any bad Symp-
tom, and does not proceed So far as to endanger the patient's life,
it ought not to be ftopped.  But when it returns frequently,  or
continues till the pulfe becomes low, the extremities begin to grow
cold,  the lips pale, or the patient complains of being fick or faint,
it muft immediately be ftopped.
  For this  purpofe, the patient fhould be fet nearly upright, with
his head reclining a little, and his legs immerfed in water about
the warmth of new milk. His hands ought  likewife to be put in
lukewarm water, and his  garters may be tied a little tighter than
ufual.  Ligatures may be applied to the arms,  about  the  place
where they are ufually made for bleeding, and with nearly the
fame degree of tightness. Thefe muft be gradually flackened as the
blood begins to flop,  and removed entirely as foon as it gives over.
  Sometimes  dry lint put up the noftrils will  flop the bleeding.
When this  does not fucceed,  doffils of  lint  dipped in ftrong fpi-
rits of wine, may be put up the noftrils, or if that cannot be had,
they may be dipped in brandy. Blue vitriol diffolved in water may
likewife be ufed for this purpofe, or a tent dipped in the white o£
an egg, well beat up, may be rolled in a  powder made of equal
parts of white fugar, burnt allum,  and white vitriol, and put up
the noftril  from whence the blood iffues*.
  Internal  medicines  can hardly be of ufe here, as they have fel-
dom time to operate.  It may not however be amifs to give the pa-
tient half an ounce of Glauber's fait,  and the fame quantity o£
manna, diffolved in four or five ounces of barley-water. This may
be taken at a  draught, and repeated,  if it does not operate, in a
few hours.  Ten or twelve  grains of nitre may be taken in a glafs
of cold water and vinegar every hour, or oftener,  if the ftomach
will bear it. If a Stronger  medicine  be  neceffary,  a tea-cupSul of
the tincture of rofes,  with twenty or thirty drops of the weak fpi-
rit of vitriol, may be taken every hour.  When thefe things cannot
be had, the patient may drink water, with a little common fait ia
it, or equal parts of water and vinegar.
  If the genitals be immerfed for fome  time in cold water, it will
generally flop  a bleeding at the  nofe.  I  have not knowntiiis fail.
  Sometimes, when the bleeding is ftopped outwardly, ||Hfntinues
inwardly. This is very troublefome, and requires partioHar atten-
tion, as the patient is  apt to be fuffocated with the blood, efpeci-
ally if he falls  afleep, which  he is very  ready to do after lofing a
great  quantity of blood.

  #• Th's intention is more  effectually anfwered by paffing abougee up
the  bleeding noftril, with  a piece of fpunge tied near the middle of it.
This may be draw n up fo as to comprefs the bleeding veffel, by bringing
the inner end of the bougee out of the uiouch.       (I. C.)
                              H 2 
BLEEDING AND BLIND PILES.
  When the  patient is in dange^oS Suffocation from the blood
getting into his throat, the paffages may be  ftopped by drawing
threads up the noftrils, and bringing them out at the mouth, then
fattening pieces of fpunge, or fmall rolls of linen cloth to their ex-
tremities ; afterwards drawing them back, and tying them on the
outfide with a Sufficient degree of tightneSs.
  ASter the bleeding is  ftopped, the patient ought  to be kept as
eaSy and quiet as poffible.  He Should not pick his nofe, nor take
away the tents or clotted blood, till they Sail  off of their  own ac-
cord, and fhould not lie with his head low.
  ThoSe who are affected  with Srequent bleeding at the nofe,
ought to bathe their Seet oSten in warm water, and to keep them
warm and  dry.  They ought to wear nothing tight about their
necks, to keep their body as much in an erect pofture as poffible,
and never  to view any object obliquely.  IS they have too much
blood, a vegetable diet, with now and then a cooling purge, is the
fafeft way to lefien ic.
  But when the difeafe proceeds from a relaxed ftate of the veffels,
the diet fhould be rich and nourifhing, as ftrong broths and jel-
lies, fago-gruel with wine and fugar,  &c. Infufions of the bark irt
wine ought to be taken and perfifted in for a confiderable time.
              Of the Bleeding and Blind Piles.

  A difeharge of blood from the hemorrhoidal veffels is called the
Heeding piles. When the veflels only Swell, and diScharge no blood,
but are exceeding painSul, the difeaSe is called the blind piles.
  PerSons oS a looSc Spungy fibre, of a bulky Size,  who live high,
and lead a Sedentary inactive life, are moft  Subject to this diSeaSe.
It is often owing to a hereditary difpofition.  Where this is the cafe,
it attacks  perfons more early in life than  when it is  accidental.
Men are more liable to it than women, eSpecially thoSe of a fan-
guine, plethoric, or Scorbutic habit, or of a melancholy difpofition.
  The piles may be occafioned  by  an exceSs of blood, by ftrong
aloetic purges, high-feafoned food, drinking great quantities of
fweet--ea«|s, the neglect of bleeding, or other cuftomary evacua-
tions, mutt riding, great coftivenefs, or any thing that occafions
hard or difficult ftools. Anger, grief, or other violent paflions, will
likewife occafion the piles, or fitting on the damp ground.  A pair
of thin breeches will excite the diforder in a perfon who is fubject
to it,  and Sometimes even in thofe who never had it before. Preg-
nant women are often  afflicted with it.
  ^ A flux of blood, from the anus, is not always to be treated as a
difeafe. It is even more Salutary than bleeding at the nofe,  and of-
ten prevents or carries off difeafes.  Iti» peculiarly beneficial in the 
          feLEEDING AND BLIND PILES.        343

gout, rheumatiSm, afthma,  and hypochondriacal complaints, and
oSten proves critical in colics, and inflammatory fevers.
  In the management of the patient, regard muft be had to his
habit of body, his age, ftrength, and manner of living.  A difeharge
which might be exceffive, and prove hurtful to one, may be very
moderate, and even falutary to another. That only is to be efteem-
ed dangerous which continues too long, and is in fuch quantity as
to wafte the patient's ftrength,  hurt the digeftion, nutrition, and
other functions neceffary to life.
   When this is the cafe, the difeharge muft be checked by a pro-
per regimen, and aftringent medicines. The DIET muft be cool
out nourifliing, confifting chiefly of bread, milk, cooling vegeta-
bles and broths.   The drink  may be  chalybeate  water, orange-
whey, decoctions or infufions of the aftringent and mucilaginous
plants, as the tormentil root, biftort, the marfhmallow-root#, &c.
   Old conferve  of red rofes is a very good medicine  in this cafe.
It may be mixed with new milk, and taken in the quantity  of an
ounce three or four times a-day.  This medicine is in no great re-
pute, owing to its being feldom taken in fuch quantity as to pro-
duce any effects  ;  but when taken as here directed, and duly per-
fifted in, I have  known  it perform very  extraordinary  cures in
violent hemorrhages, efpecially when affifted by the tincture of
rofes ; a tea-cupful of which may be taken about an hour after eve-
ry dofe of the conferve.
   The bark is likewife proper in this cafe, both as a ftrengthener
and aftringent. Half a drachm may be taken in a glafs of red ^ine,
Sharpened with a few drops of the elixir of vitriol, three or four
times a-day.
   The bleeding piles are fometimes periodical, and  return regu-
larly once a-month, or once in three weeks. In this cafe, they are
 always to be confidered  as a falutary difeharge, and  by no means
 to be  ftopped. Some have entirely ruined their health by Stopping
 a periodical difeharge of blood from the hemorrhoidal veins.
   In the blind piles, bleeding is generally of ufe. The diet muft be
light and thin, and the drink cool and diluting. The body muft be
 kept gently open.  This may be done by fmall  dofes of the flowers
 of brimftone and cream of tartar.  Thefe may be  mixe^in equal
 quantities,  and a tea-fpoonful taken two or three tin^^ftday, or
 oftener if neceffary.  Or an ounce of the flours of brWpbne, and
 half an ounce of purified nitre, may be mixed with three or four
 ounces of  the  lenitive electuary,  and a tea-fpoonfuT of it taken
 three  or four times a-day.
   Emollient clyfters are here likewife beneficial; but there is fome-
 times fuch an aftriction of the anus, that they cannot be  thrown
 up. In this cafe, a vomit has had a very good effect.
   When the piles are exceeding painful and fwelled, but difeharge
 nothing, the  patient muft fit over the fleams of warm water. He
 may likewife  apply a linen cloth dipped in warm fpirits^of wine  t# 
244            SPITTING OF BLOOD.
the part, or poultices of bread and milk. If thefe do not produce a
difeharge,  and the piles appear large, leeches muft be applied as
near them  as poffible, or, if they will fix upon the piles themfelves,
fo much the better.  When leeches will not fix, the piles may be
opened with a lancet.   The operation is very eafy, and is attended
with do danger.
   Various  ointments, and other external applications,  are recom
mended in  the piles ; but I do not remember any effects from thefe
worth mentioning. Their principal ufe is to  keep the part moift,
which  may be done as well by a foft poultice, or an emollient ca-
taplafm.  When the pain however is very great,  a liniment made
of two ounces of emollient ointment,  and half an ounce of lauda-
num, beat  up with the yolk of an egg, may be applied.
                        Spitting  of Blood.

   WE mean here to treat of the difeharge of blood from the lungs
 only which is called an hamoptoe, or fpitting of blood.  Perfons of a
 flender make, and a lax fibre,who have long necks and Strait breafts,
 are moft liable to this diSeaSe. It is moft common in the Spring, and
 generally attacks people bcSore they arrive at the  prime or middle
 period oS liSe.  It is a common observation, that thoSe who have
 been Subject to bleeding at the noSe when young, are aSterwards
 moft liable to an haemoptoe.
   CAUSES-----An hsemoptoe may proceed from excefs of blood,
 from a peculiar weaknefs in  the lungs, or a bad  conformation of
 the breaft, exceffive drinking, running, wreftling, finging, or Speak-
 ing aloud. Such as have weak lungs ought to avoid all violent ex-
 ertions oS that organ, as they value life.  They  fhould likewiSe
 guard againft violent paffions, exceffive drinking,  and every thing
 that occafions a rapid circulation of the blood.
   This difeafe may proceed  from wounds of the  1 ungs.   Thefe
 may either be received from  without, or they may be  occafioned
 by hard bodies getting  into the wind-pipe,  and  So  Sailing down
 upon tjjBhngs, and hurting the tender organ.  The obftruction of
 any cuflpBary evacuation may occafion a Spitting oS blood; as ne-
 glect oS^bufeding or purging at the uSual feafons, the ftoppage of
. the bleeding piles in men,  or the menfes in  women, &c.   It may
 likewife proceed from  a polypus,  fehirrous concretions,  or any
 thing that obftructs the circulation of the blood  in the lungs.  It
 is often the effect  of a long and violent cough ; in which cafe, it
 is generally the forerunner of a confumption. A violent degree of
 cold fuddenly applied to the external parts of the body, will occa-
 fion an hsemoptoe. It may  likewife be occafioned by breathing air
 which is too much rarified to be able properly to expand the lungs.
 This is often the cafe with thoSe who work in hot places,  as Sur- 
SPITTING  OF  BLOOD.            245
naccs, glafs-houSes, or the like.  It is  likewiSe Said to happen to
Such as aScend to the top of very high mountains, as the Peak of
Teneriffe, &c.
  Spitting of blood is not always a primary difeafe. It is often only
a fymptom, and in fome difeafes not an unfavourable one.. This is
the cafe in pleurifies,  peripneumonies,  and fundry other fevers.
In a dropfy, feurvy, or confumption, it is a bad fymptom, and fhows
that the lungs are ulcerated.
   SYMPTOMS.----Spitting of blood is generally preceded by
a fenfe of weight, and oppreffion of the breaft, a  dry tickling
cough, hoarfenefs, and a difficulty of breathing.  Sometimes it is
ufhered in with fhivering, coldnefs of the extremities, coftivenefs,
great laffitude, flatulence, pain of the back and loins, &c.  As thefe
Show a general Stricture upon the veffels, and  a tendency of  the
blood to  inflammation, they are commonly the forerunners of a
very ccpious  difeharge. The above fymptoms do not attend a  dif-
eharge of blood from the gums or fauces, by which means thefe
may always be diftinguifned Srom an hsemoptoe.  Sometimes  the
blood that is Spit up is thin, and of a florid red colour; and at
other times it is thick,  and of a dark or blackifh colour; nothing
can be inferred from this circumftance, but that the blood has lain
a longer  or fhorter time in the breaft before it was difcharged.
   Spitting of blood, in a ftrong, healthy perfon, of a found con-
ftitution, is not very dangerous; but when it attacks the tender
and delicate,  or perfons of a weak lax fibre, it is with difficulty re-
moved. When it  proceeds from a fchirrus of the lungs,  it is bad.
The danger is greater when the difeharge proceeds Srom the rup-
ture oS a large veffel than of a Small one.  When the extravaSated
blood is not Spit up, but lodges in the breaft, it corrupts, and great-
ly increafes the danger. When the blood proceeds Srom an ulcer
in the lungs,  it is  generally fatal.
   REGIMEN.----The patient ought to be  kept cool  and ealy.
Every thing that heats the  body or quickens the circulation, in-
creafes the danger.  The mind ought likewiSe to be Soothed,  and
every occafion of  exciting  the-paffions avoided.  The diet fhould
be  foft, cooling, and  flender; as rice  boiled  with milk,  fmall
broths,  barley-gruels,  panado, &c.  The diet, in thrscafe,  can
fcarce be too  low.  Even water-gruel is fufficient toJStortthe
patient for fome days.  All ftrong liquors muft be  aiW.  J he
patient  may   drink  milk and  water, barley-water, whey, but-
ter-milk, ana fuch-like. Every thing fhould be drank cold  and in
fmall quantities at a time.  He fliould obferve the llrfeteft filence,
or at leaft fpeak with a very low voice.
   MEDICINE ■____This, like the other involuntary difcharges of
blood, ought  not to be fuddenly ftopped by aftringent medicines.
More mifchief is often done by thefe, than if it were fuffered to
go on.  I   may, however, proceed fo far as to weaken the patient, 
246          VOMITING  OF BLOOD.
and even endanger his life; in which cafe, proper mearts mull be
ufed for xeftraining it.
  The body fhould be kept gently open by laxative diet; as roaf-
ted apples, ftewed prunes,  and Such-like. If thefe fliould not have
the defired effect, a tea-fpoonful  of the lenitive electuary may be
taken twice or thrice a-day, as is found necefiary. If the bleeding
proves violent, ligatures may be applied to the extremities, as di-
rected for a bleeding at the nofe.
  If the patient behot or feverifh, bleeding and fmall dofes of nitre
will be af ufe ;  a Scruple or half a drachm of nitre may  be taken
in a cup of his ordinary drink, twice or thrice  a-day.  His drink
may be fliarpened with acids,  as juice of lemon, or a few drops of
the fpirit of vitriol; or he  may take frequently a cup of the tinc-
ture of rofes.
  Bathing the feet and legs in lukewarm water, has a very good
effect in this difeafe.  Opiates are fometimes beneficial;  but muft
be adminiftered with caution. Ten or twelve drops of laudanum
may be given in a  cup of barley-water twice a-day, and continu-
ed for fome time, provided they be found beneficial.
  The conferve of rofes is  a  very good  medicine in this cafe, if
taken in fufficient quantity, and long enough perfifted in. It may be
taken to the quantity of three or four ounces a-day ; and, if the
patient be troubled with a  cough, it fhould be made  into an elec-
tuary with balfamic fyrup,  and a little of the fyrup of poppies.
  If Stronger aftringents be necefiary, fiSteen or  twenty drops of
the elixir of vitriol may be given in a glafs of water, three or four
times a-day.
  Thofe who are fubject to frequent returns of this difeaSe, fhould
avoid all exceSs.  Their diet  fliould  be light  and cool, confifting
chiefly of milk  and vegetables.  Above all, let them beware of vi-
gorous efforts of the body, and violent agitations of the mind.
                     Vomiting of Blood.

  THISts not fo common as the other difcharges of blood alrea-
dy menflfejed; but it is very dangerous,  and requires particular
attentiorr™P
  Vomiting of blood is generally preceded by pain of the ftomachj
ficknefs, and  naufea;  and  is accompanied with great anxiety, and
frequent fainting fits.
  This difeafe is fometimes periodical;  in which  cafe, it is lefs
dangerous.  It often proceeds from an obstruction of the menfes
in women ;  and fometimes from the flopping of the hemorrhoidal
flux in men. It may be occafioned  by any thing that greatly Stimu-
lates or wounds  the ftomach, as ftrong vomits or  purges,  acrid  ^
poifems, fharp or hard fubftances taken into the ftomach, &c. It la 
BLOODY  URINE,
*47
often the effect of ohftructions in the liver, the fpleen, or fome
of the other vifeera, or external violence a3 blows  or bruifes, or
any of the caufes which produce inflammation.  In hyfteric wo-
men, vomiting of blood is a very common, but no dangerous fymp-
tom.
   A great part of  the danger in this difeafe arifes from the ex-
travafated blood lodging in the bowels, and becoming putrid, by
which a dyfentery or malignant fever may be occafioned. The belt
way of preventing this, is co keep the body gently open, by fre-
quently exhibiting emollient clyfters.  Purges mult not be  given
till the difeharge is ftopt, otherwife they will irritate the ftomach,
and  increafe the diforder.   All the food and drink muft be of a
mild cooling nature, and taken in fmall quantities.  Even drink-
ing cold water has  fometimes proved a remedy, but it will fucceed
better when fharpened with the  weak fpirits of vitriol \  When
there are figns  of  an inflammation, bleeding may be neceffary ,
but the patient's weaknefs will feldom  permit it. Opiates may be
of ufe; but they muft be  given  in  very fmall dofes, as four or
five drops of laudanum twice or thrice a-day.
   After the difeharge is over, as  the patient is generally troubled
with gripes, occafioned by the acrimony of the blood lodged in the
inteftines, gentle purges will be neceffary.
                      ~Of Bloody Urine*

   THIS is a diScharge of blood from the veffels of the kidneys ot
bladder, occafioned by  their being either enlarged,  broken, or
eroded. It is more or lefs dangerous according to the different cir-
cumftances which attend it.
   When pure blood is voided fuddenly without interruption and
without pain, it proceeds from the kidneys ;  but if the blood  be in
fmall quantity, of a dark colour, and emitted with heat and pain
about the bottom of the belly, it proceeds from the bladder. When
bloody urine is occafioned by a rough ftone defcending from the
kidneys to the bladder, which wounds the ureters, it Jkattended
with a fharp pain in the back, and difficulty of makin^Pvater. If
the coats of  the bladder are hurt by a ftone, and the bloody urine
follows, it is attended with the moft acute pain, and  a previous
ftoppage of urine.
   Bloody urine  may likewife be occafioned by falls,  blows, the
lifting or carrying of heavy burdens,  hard  riding, or any violent
motin. It may alfo proceed from ulcers of the bladder, from a  ftone

  * Clyfters of cold water, with forty or  fifty drop? of hudwuim ia
each, fhould be injected,  aad ftillocfi. UrfeUy eajo'ui«ft.      <r. C.; 
  248              THE DYSENTERY,

 lodged in the kidneys, or from violent purges, or fliarp diuretic
 medicines, efpecially cantharides.
    Bloody urine is always attended with fome degree of danger:
 but peculiarly fo when mixed with purulent matter, as this fhows
 an ulcer  fome where in the urinary paffages.  Sometimes this dif-
 eharge proceeds from excefs of blood, in which cafe it  is rather a
 falutary evacuation than a difeafe.   If  the difeharge however be
 very great, it may wafte the patient's ftrength, and occafion an ill
 habit of body, a dropfy, or a confumption.
    The treatment of this diforder muft be varied, according to the
 different  caufes from which it proceeds.
    When it is owing to a ftone in  the bladder, the cure depends
 upon an operation ; a defcription of which would be foreign to our
 purpofe.  If attended with a plethora, and fymptoms of inflam-
 mation, bleeding will be neceffary.  The body muft likewiSe be
 kept open by emollient clyfters, or cooling purgative medicines;
 as cream oS tartar, manna, or Small doSes oS lenitives electuary.
    When bloody urine occurs in malignant difeafes, as the Small-
 pox, fevers, or the like, the patient's hSe depends on the liberal ufe
 of the bark and acids, as already Shown.
    When there is reaSon to SuSpect an ulcer in the kidneys or blad-
 der, the patient's diet muft be cool, and his drink oS a SoSt. heal-
 ing, b'alSamic quality, as decoctions of  marfh-mallow roots with
 liquorice, folutions of gum-arabic,  &c.   Three ounces of marfh-  -
 mallow roots, and half an ounce of liquorice,  may  be boiled in
 two Englifh  quarts of water to one ; two  ounces of gum-arabic
 may be diffolved in the ftrained liquor, and a tea-cupful oS it taken
 four or five  times a-day.
   The early  ufe of aftringents in this difeafe has often bad con-
 fequences.    When the  flux is  ftopped too foon, the grumous  i
 blood, confined in the veffels, may produce inflammations, abfeefs,
 and ulcers. If the caufe be urgent, or the  patient feems to fulfer  ,
 from the lofs of blood, gentle aftringents may be neceffary. In this  ,
 cafe, the patient may take three or  four ounces of lime-water,
 with half an  ounce of the tincture of bark, three times  a-day, or  .
 more frequent if neceffary.




              Of the Dyfentery,  or Bloody Flux.

   THIS difeafe prevails in the fpring and autumn. It is moft com- '
 anon in  marfhy countrLs, where, after hot and dry fummers, it is •
 apt to become epidemic.  Perfpns are moft  liable  to it, who are
 much expofed to  the  night ai£, or who live  in  places  where
the air is confined and unwholefome.  Hence, it often  proves fa-
tal in camps, on fliipboard, in gaols, hofpitals, and fuch-like places. 1 
                 OR  BLOODY FLUX.              249

  CAUSES-----The dySentery may be occafioned  by any thing
that obftructs the perSpifatio^n ; as damp beds, wet clothes, un-
wholefome diet, air, &c. But it is moft frequently communicated
by infection.   This ought to make people extremely cautious, in
going near fuch perfons as  labour under the  difeaSe.  Even the
Tmeli of the patient's excrements has been known to dommuni-
cate it.
   SYMPTOMS.----It is known by a flux of the belly,  attended
with violent pain of the bowels, a  conftant inclination to go to
ftool, and  generally more or  lefs blood in the  ftools. It begins,
like other fevers, with chillnefs, lofs of ftrength, a  quick pulfe,
great thirft, and an inclination to vomit.  The  ftools' are at firft
greafy and frothy, afterwards  they are Streaked with blood, and ac
laft, have  frequently the appearance of pure blood, mixed with
fmall filaments refembling bits of fkin. Worms are fometimes paf-
fed both upwards  and  downwards through the whole courfe of
the difeafe.  When the patient  goes to Stool, he Seels a bearing
down, as if the whole bowels were falling  out, and fometimes a
part of the inteftine is actually protruded, >vhich proves exceeding
troublefome, efpecially in children.  Flatulency is a troublefome
fymptom, efpecially towards the end of the difeafe.
   This  difeafe  may  be diftinguifhed from  a diarrhoea or loofe-
nefs, by the  acute pain of the bowels, and the blood which ge-
nerally appears in the ftools ; and from the cholera morbus, by its
not being attended with fuch violent and frequent fits of vomit-
ing, &c.
   When the dyfentery attacks the old, the delicate, or fuch as
have been wafted by the gout, the feurvy,  or other lingering dif-
eafes, it generally proves fatal.  Vomiting and hiccuping are bad
fi-ms, as they fhow an inflammation of the ftomach. When the
ftools are green, black, or have an exceeding difagreeable cadave-
rous fmell, the" danger is very great, as it Shows the diSeaSe to be
of the putrid kind.  It is an unSavourable Symptom  when  clyfters
are immediately returned ; but ftill more So, when the paffage is
fo obftinately fhut, that they cannot be injected.   A feeble pulfe,
coldnefs of the  extremities, with difficulty of fwallowing, and con-
vulfions, are figns of approaching death.
   REGIMEN.----Cleanlinefs contributes  greatly to the reco-
very of  the patient, and the SaSety of fuch as attend t|hri.  In all
contagious difeaSes,  the danger  is increaSed,  and th"e infection
fpreadj by the neglect of cleanlinefs; but in rto one more than
this.  Every thing about the patient fliould be frequently changed.-
The excrements fliould never be  Suffered to  continue in his cham-
ber, but  removed immediately, and buried under ground. A con-
ftant ftream of frefh air fhould be admitted into the chamber ; and
it ought frequently to be fprinkled with vinegar, juice of lemon,
or fome other ftrong acid.
   The patient  muft not be difcouraged, but his Spirits kept up in
                             I  1 
25o               THE DYSENTERY,

hopes of a cure. Nothing tends more to render any difeafe mor-
tal, than the fears and apprehenfions of the fick. All difeafes of
this nature have a tendency to fink and deprefs the fpirits, and when
that is increaSed by Sears and alarms, from thoSe whom the pa-
tient believes to be perSons of fkill, it cannot Sail to have the worft
effects.
  A flannel waiftcoat worn next the fkin  has  oSten a  very good
effect in  the dyfentery.   This promotes the perfpiration  without
over-heating the body.  Great caution is neceffary in leaving it off.  i
I have  often known a dyfentery brought on by imprudently throw-
ing off a flannel waiftcoat before the feaSon was Sufficiently warm.. •
For whatever purpoSe this piece of drefs is worn, it fhould never
be left off but in a warm feafon.
  In this difeafe, the greateft attention muft be paid to the pa-
tient's  diet. Flefh, fifli, and every thing that has a tendency to turn
putrid  or rancid on the ftomach, muft be abitained Srom. Apples*
boiled  in  milk, water-pap, and plain,  light pudding,  with broth
made oS the gelatinous parts of animals, may conftitute the prin-
cipal part of the patient's food. Gelatinous broth not only anfwers
the purpofe of food, but likewife of medicine.  I have often known
dyfenteries, which were not of a putrid nature, cured by it after
pompous  medicines had proved ineffectual*.
  Another  kind of food very  proper in the dyfentery, which may
be ufed by  Such as cannot take  the  broth mentioned above, is
made by boiling a few handfuls of fine flour,  tied in a cloth, for   I
fix or feven hours, till it becomes as hard as ftarch. Two or three
table-fpoonfuls of this may  be grated down, and boiled in fuch a
quantity of new milk and water, as to be of the thicknefs of pap.
This may be fweetencd to the patient's tafte, and taken for his or-
dinary foodf.

  * The manner of making this broth is, to take a fheep's-head and
feet, with the Ikin upon them, and to burn the wool off with a hot iron;
afterwards to boil them till the broth is quite a jelly.  A little cinna-
mon or mace may be added, to give the  broth an agreeable flavour,
and the patient may take a little of it warm with toafted bread, three
or four times a-day. A clyfter of it mny likewife be given twice a-day.
Such as cannot life the broth made in this way, may have the head and
feet ikinned ; but we have reafon to believe,  that this hurts the medi-
cine. It is rjpt our bufinefs here ro reafon upon the nature and qualities
of medicine, otherwise this might be  fliown to poflefs virtues everyway
fuited to the cure of a chfcntery which does not proceed from a putrid
ftate of the humours. Whole families have often been cured by it, af-
ter they had ufed many other  medicines in vain. It will, however, be
proper that the patient take a vomit, and a dofe  or two of rhubarb,,
oef ore  he  begins to ufe the broth. It will likewife be necelfary to con-  '
tinue the me of it for a confiderable time, and to make it the i-rincipaJ j
food.                                                   l        M
 m t The '.earned and humane Dr. Rutherford, late profeflbr of medi-
cine m  the umverht-y of Edinburgh, ufed to  mention this food in his  .
puo.ic  lectures with great encomiums. He directed it to be made by
iyii;g a pu.t,id or two oi the fined: 'dour, as tight as poflibfe, in a linen 
OR  BLOODY FLUX.
,  In dyfentery, the patient may be allowed to eat freely of moft
kinds of ripe fruit; as apples, grapes, goofeberries, currant-ber-
ries, Strawberries, &c. TheSe may either be eaten raw or boiled,
with or without milk, as the patient choofes. The prejudice againft
fruit  in this diSeaSe, is So great, that many believe it to be the
common  cauSe oS dyfenteries.   This  is an  egregious  miftake.
Both reaSon and experience fhow,  that good Sruit is one of the
beft medicines, both Sor the prevention and cure oS the dyfemeiy.
Good fruit is in every refpedt calculated  to counteract  that ten-
dency  to putrefaction, from  whence  the moft dangerous kind
of dyfentery proceeds.  The patient, in Such a caSe, ought  to be al-
lowed to eat as much fruit as he pleafes, provided  it be npe*.
   The moft proper drink in this diforder,  is whey or fl ixfeedtea.
The  dyfentery has oSten been cured by the ufe  of clear whey
alone.  It may be taken  both for drink and  in form of  clyfter.
When  whey cannot be had, barley-water  fharpened with cream
of tartar may be drank, or : decoction of  barley and tamarinds ;
two ounces of  the former and one of the latter, may be boiled in
two Englifh quarts of  water to one.   Warm  water, water-gruel,
or water wherein hot iron  has been frequently quenched, are all
very proper, and may  be drank in turns.   Camomile-tea, if the
ftomach will bear it, is an exceeding proper  drink. It both Strength-
ens the ftomach,  and  by  its antiSeptic quality, tends  to  prevent
a mortification of the b wels.
   MEDICINE.----At the beginning^of this  difeafe, it is always
necefiary  to cleanfe the firft pafiages. For *his, purpofe,  a vomit
of ipecacuanha mud be given, and' wrought off with weak camo-
mile tea.  Strong vomits are feldom necefiary  here.  A  Scruple, or
at moft, half a drachm of ipecacuanha, is generally fufficient for an
adult, and fometimes a  few grains will fuffice. The day  after the

rag. after wards'to dip it frequently in water,  and to dridge theoutfide
with flour, till a cake or  emit was formed around" it,  which  prevents
the water from foaking into it while boilin g. It is then to be Uoi'ed till
it becomes a hard, dry mafs, as directed above. This, when mixed with
milk and water, will not only anlwer the purpofe  of  food,  but may
likewife be given in clyfters.
  #. I  lately faw a young man who had-been feized with a dyfentery
in North-America. Many things had been tried there for his relief,
but to no purpofe.  At length, tired out with disappointments irom me-
dicine,  and reduced to ikin and bone, he tame over to Britain, rather
v ith a'view to die among his relations,  than with any hopes of a cure.
Aft^r taking funciry medicines hero wirh no better fuccefs than abroad,
]  advifed him to leave off the ufe of drugs, and  to mill entirely to  a
diet of  milk and fruif., with gentle exercife. Strawberries was the
only Fruit he could procure  at that feafon.  'Thefe he are with milk
twice, and fometimes thrice a-day.  The confluence was,  Mat in a.
fhort time his ftools were rednced,from upwards or twenty  m a-day,
to three or four, and fometimes not fo many,  fie ufed the othtr fruits
as they came in, and was in a few weeks fo well as to leave that part
of the c«un:rv where I  w.w, *irh a view to return to America. 
252           THE DYSENTERY, Sec.

vomit, half a drachm, or two Scruples of rhubarb muft be taken j
or,  what will anfwer the purpofe rather better, an ounce or an
ounce and a half of Epfom falts. This dofe may be repeated every
other day, for two or three times. Afterwards fmall dofes of  ipe-
cacuanha maybe taken for fome time.  Two or three grains of the
powder may be mixed in a table-SpoonSul of the fyrup of poppies,
and taken three times a-day.
  Thefe evacuations, and the regimen prefcribed above, will of-
ten be fufficient to effect a cure. Should.it, however, happen other-
wife, the following aftringent medicines may be ufed.
  A clyfter of Starch or Sat  mutton-broth,  with thirty  or  Sorty
drops oS liquid laudanum in it, may be adminifterd twice a-day.
At the  Same time an ounce oS gum-arabic, and halS an ounce of
gum-tragncanth, may be  diflblved in an Englifh pint of barley-
water, over a flow  fire,  and a  table-fpoonful of it taken every
hour.*
  If thefe have not  the defired effect, the patient may take  four
times a day, about the bulk of a nutmeg of the  Japonic confection,
drinking after it a tea-cupful of the deco£tion of logwoodf.
  Perfons  who have been cured of this difeafe are very liable to
a relapfe;  to prevent which, great circumfpedtion as to diet  i$
neceffary.  The patient muft abftain  from all fermented liquorsi
Cxcept now-and-then a glafs of good ,wine ; but he muft drink no
kind of malt liquor.  He Should likewiSe abftain Srom animal food,
as fifh and flefh, and live principally on milk and vegetables.
   Gentle exercife and wholefome air  are likewife of importance.
The patient fhould go to  the  country as Soon as his ftrength will
permit, and take exerciSe daily oh horSeback, or in a carriage. He
may likewiSe uSe bitters inSuSed in wine 6r brandy, and may drink
twice a-day a gill of lime-water mixed with an equal quantity  of
new milk.  .
   When dyfenteries prevail, we would recommend a ftric~r. atten-
tion to cleanlinefs, a fpare ufe of animal food, the free ufe of foufid
ripe fruits  and other vegetables.  The night air is to  be carefully

  * The indications of cure in this difeafe are more effectually anfvver-
ed, by giving a drachm of Glauber falts eve\y hour, fo  as to clear the
bo weis of hardened excrement, by exciting briik purging. This plan fhould
be continued until the griping and tenel'mus fubfide, interpofmg  every
night at bed-time one or two grains of opium, combined with two or
rhree of-ipecacuanha to quiet  the bowels and promote  perfpiration.
If the patient cannot  take falts, one table fpoonful of* caftor oil fliould
be  given, and repeated every two or three hours, until it  produces the
defired effect of rendering the ftools more copious ;  and after they ap-
pear in lumps or balls, the  cure muft be followed up, by giving infufion
or  bark, as frequent and in as large dofes as the itomach will  bear.
1 his praftice is equally applicable to children, by accomniodatine; the
dofes of medicin to their age*     (I. C.)

  t See Appendix, Decoction of Logwoed. 
THE  HEAD-ACH.
avoided, and all communication with the fick. Bad fmells are to
be Shunned, eSpecially thqSe which ariSe Srom putrid animal Sub-
stances.  The neceflTaries  where the fick go fhould be carefully
avoided by thofe in health.
   Sundry other fluxes of the belly, as the LIENTERY and CCE-
LIAC PASSION, though lefs dangerous than the dyfentery, yet
merit consideration.  TheSe diSeaSes  generally proceed Srom a re-
laxed ftate  of the ftomach and inteftines,  which is fometimes So
great, that the food pafles through them without almoft any fen-
fible alteration •, and the  patient dies merely  from the want of
 nourifhment.
   When the  lienrery  or  cceliac paffion fucceeds to a dyfentery,
 the cafe is bad. They are always dangerous in old age, efpecially
 when the conftitution has been broken by excefs cr acute difeafes.
 If the ftools be very- frequent, and  quite crude, the thirft great,
 with little urine, the mouth ulcerated, and the face marked with
 Spots of different colours, the  danger is very great.
    The treatment of the patient is in  general the fame as in the
 dyfentery.  In all obftinate fluxes of the belly,  the cure muft be
 attempted, by firft cleanfing the ftomach and bowels, with gentle
 vomits and purges ; aSterwards, Such diet as has  a  tendency to
  heal and Strengthen the bowels, with opiates and aftringent medi-
  cines,  will generally perfect the cure.
    The fame obfervation holds with refpect to a TENESMUS, or
  frequent defire of going to ftool.  This difeafe  refembles  the dy-
  fentery fo  much, both in  its fymptoms and method of cure, that
  we think it needlefs to in Sift  upon it.
             CHAPTER  XXXVI.

                    Of the Head-Ach.

     AC H S and pains proceed from very different caufes, and
       may  affect any part of .the body ;  but we fhall point  out
thofe only which occur moft Srequently, and are attended with the
greateft danger.                                ' ~
  When thp head-ach is flight, and affects a particular part of the
head only, it is called cephalalgia ; when the whole head is affected,
ceplxilaa \ and when on one fide only, kemicrania. A fixed pain in
the forehead,' which maybe covered v. uh the end of the thumb,
is called the clavis l:\flericus.                        #  # #
  There are alfo other distinctions.  Sometimes the pain is inter-
nal, Sometimes externa! ;  Sometimes it is  an original difeafe, and
at  other times only Symptomatic.  When the head-ach proceeds
Srom a hot  bilious  habit, the pain is very acute and throbbing,
wkh a confiderable heat oS the part affecixd. Wh-.u Srom a cofd 
 £54               THE I IE AD-ACH.

 phlegmatic habit, the  patient complains of a dull heavy pain, and
 has a fenfe of coldnefs  in  the  part.  This  kind  of head-ach is
 fometimes attended with a degree of ftupidity or folly.           •
   Whatever  obftructs the free  circulation of the blood through I
 the veffels of the head, may occafion a head-ach. In perSons of a
 full habit, who abound with blood, or other humours, the head-
 ach often proceeds from the fuppreffion oScuftomary evacuations;
 as bleeding at the nole,(Sweating oS the Seet, &c. It may likewiSe
 proceed Srom any cauSe  that determine-s a great flux oS blood to-
 wards the head ; as coldneSs oS the extremities, or hanging dowri ''
 the  head Sor a long time.  Whatever  prevents  the  return -of the
 blood Srom the head  will occafion  a head-ach ; as  looking long
 obliquely at any object, wearing any thing tight about the neck,
 or the like.
   When a head-ach proceeds Srom  the  ftoppage of a running at
 the  nofe, there is a heavy, obtufe, preffing pain in the fore-part of
 the  head, in which there feems  to be fuch  a weighty that the pa-
 tient can fcarce hold it up. When  it is occafioned by the cauftic
 matter oS the veneral diSeaSe, it generally affects the Skull, and of-
 ten  produces a caries of the bones.
   Sometimes the head-ach proceeds from the repulfion or retro.
 eeffion of the gout, the eryfipelas, the Small pox, meafles, itch, or   \
 other eruptive diSeaSes.  What  is called a hemicrania generally
 proceeds Srom crudities or indigeftion.  Inanition, or emptinefs,
 will alSo occafion head-achs, as in nurSes who gave Suck too long,
 or who did not take a Sufficient quantity  of Solid Sood.
   There is likewiSe a moft violent, fixed, conftant, and almoft in-  i
 tolerable head-ach,  which occafions  great debility both  of body
 and  mind, prevents fleep, deftroy s the appetite, caufes a%w/iVo,
 dimnefs  of fight, a noife in the ears, convulfions, epileptic fits, and  ,
 fometimes vomiting, coftiveneSs, coldneSs cS the extremities, &c.
   The head-ach is often Symptomatic in continual and intermit-
 ting fevers, efpecially  quartans.  It is likewife  a. very common
 fymptom in hyfteric and hypochondriac  complaints.
   When a head-ach attends an acute fever, with pale wine, it is
 an unSavourable Symptom.  In exceffive head-achs, coldnefs of the
 extremities is  a bad Sign. •
   When thediSeaSe continues fer-g, and is very violent, it often
 terminates in blmdneSs, an apoplexy, deaSneSs, a vertigo, the palSy,
 epileply, See.
   The cool regimen in general  is to be obServed. The diet ought
 to confift oS Such emollient Subftances as will correct the acrimo-
 ny (•[ the humour?, and keep the body open ;  as apples boiled in
 milk, Spinago, turnips,  and  fu.-.h-like. The drink ought to be di-
luting ; as br.rey-waier, iiJufious oS r.iiid mucilaginous vegeta-^
blc, decoctions cS the  iudorific  wood/., Sec.   The  feet and legs ■
ought to be kept warm, and Srequently bathed in lukewarm v;i-
ter ;  the head  fhould be feaved, and bathed with water and vine-« 
THE  HEAD-ACH.
*SS
gar.  The patient ought as much as poffible to keep in an erect:
pofture, and not to lie with his head too-low.
  When the head-ach is owing to excefs of blood, or a bilious
conftitution, bleeding is neceffary.  The patient may be bled in the
jugular vein, and the operation repeated if there be occafion.
Cupping alfo, or  the application of leeches to the temples, and
behind the ears, will be of fervice.   Afterwards a blifter may be
applied to  the neck, behind the ears, or to an< part of the head
that is moft affected. In fome cafes it will be proper to  blifter the
whole head. In ptrSons of a grofs habit, iffues or perpetual blifters
will be of fervice.  The body ought likewiSe to be kept open by
.gentle laxatives.
   But when there is a dull, heavy, continual  pain in  the head,
which will neither yield to bleeding nor gentle laxatives,  then
more powerSul purgatives are neceffary, as  pills made of aloes,
refin oS jalap, or  the like.  It will alfo be neceffary in this cafe
to blifter the whole head, and to keep the back part of the  neck
open for a  confiderable time by a perpetual blifter.
   When the head-ach is occafioned by the ftoppage of a rupning
at the  nofe, the patient Should  frequently fmell to  a bottle of
volatile falts •,  he may likewife take fnuff, or any thing that will
irritate the nofe, fo as to promote  a  difeharge  from  it;  as the-
herb maftich, ground-ivy, &c
   A hemicrania,  efpecially  a  periodical  one,  is generally owing
to  a foulnefs of the ftomach,  for which gentle vomits muft be
acfminiftered, as  alfo purges of Glauber falts or jalap.   After the
bowels have been fufficiently cleared, chalybeate waters, and fuch
bitters as Strengthen the ftomacha  will be neceffary.
   When^ the head-ach is fo  intolerable  as to endanger  the pa-
tient's lire, or is attended with continual watching, delirium, ,&c.
recourfe muft be had to opiates.   Thefe, after proper evacua-
tions by clyfters or nilld purgatives,  may be applied both exter-
nally and  internally.  The affected part  may  be  rubbed  with
Bate's anodyne balfam, or a cloth dipped in it may be applied to
the  part.   The patient may, at the fame time, take twenty drops
of laudanum, in a cup of valerian  or penny-royal tea, twice or
thrice a-day.  This is  only to be done in cafe of extreme pain.
Proper evacuations ought always to accompany and follow the ufe
of opiates*.
   Y/hen the patient cannot bear die lofs of blood, his feet ought
Srequently to be  bathed in luke-warm water, and well  rubbed
with a coarSe cloth.  CataplaSms  with  muftard or  horSeradifh
ought likewiSe to be applied to them.  This courSe is peculiarly
neceffary when the pain proceeds Srom a gouty humour affecting
the head.

  * When tie pain is very violent, and does not yield to fmall dofes of
laudanum,  riie quantity may be.increaied.  1 have known a patient in
extreme pain rake thies hundred drops in jwenty-four hours j but fuch
tlcl'es ought only to be aduiiuiftereci by perfoni of fkiH. 
2S6               THE  TOOTH-ACH.

  When the  head-ach is occafioned by great heat, hard labour,
or violent exerciSe of any kind,  it may be allayed by cooling me-
dicines ;  as the Saline draughts with nitre,  and the like.
  A little oS Ward's effence, dropt into the palm of the hand, and
applied  to  the forehead, will fometimes remove a violent head-
ach ; and fo will sether, when applied in the  fajne manner.
                     Of the Tooth-Ach.

   THIS difeaSe needs no description.   It has great affinity with
the rheumatiSm, and oSten  Succeeds pains of  the fhoulders and
other parts of the body.
   It  may  proceed  from  obstructed perfpiration, or any oS the
other cauSes oS inflammation, from neglecting fome  part of the
ufual coverings of vthe head ;  or  from fitting with(the head bare
near  an open window,  or expofing it any how to a draught of
cold»air.  Tood or drink taken either too hot or too  cold is very
hurtful to the teeth.  Great quantities oS Sugar, or other Sweet-
meats,  are likewiSe hurtSul.   Nothing  is more deftructive to the
teeth than cracking nuts, or chewing any kind of hard Substances.
Picking the teeth with pins, needles, or any thing that may hurt
the enamel with which they are covered, does great mifchief, as
the tooth is  fure to  be  Spoiled whenever the  air gets into it.
Breeding women*are very Subject to the tooth-ach, efpecially dur-
ing the firft three or four months of pregnancy.  The tooth-ach
often proceeds from  Scorbutic humours affecting the gums.   In
this caSe, the  teeth are Sometimes wafted, and Sail out without any
confiderable degree  oS pain.   The more immediate  caufe oS the
tooth-ach is a rotten or carious tooth.
   In  order to relieve  the  tooth-ach, we muft firft endeavour to
leffen the flux of humours  to the part affected.  This may  be done
by mild purgatives, Scarifying the gums, of  applying leeches to
them, and bathing the  feet frequently with warm water.  The
perfpiration ought likewife to be promoted, by drinking freely of
weak wine-whey, or  other  diluting liquors,  with fmall  dofes of
nitre.   Vomits, too,  have often an exceeding good effect in the
tooth-ach.   It  is feldom fafe to adminifter opiates, or any kind
of heating-medicines,  or  even to draw a tooth, till proper evacu-
ations have been premifed; and thefe alone will often effect the
cure.
   If this fails, and the pain and inflammation ftill increafe, a fup-
puration maybe expected , to promote which, a toafted fig fhould
be held between the gum and tire cheek ; bags filled with boiled
camomile flowers,  flowers of ehler, or tht like, may be applied
near the part- affected,  with  as great a  degree of warmth as the
patient  can bear, and renewed as  they grow cool:  the patient 
                 THE  TOOTH-ACH.               btf

may likewife receive the  fteams of warm water into his mouth,
through an  inverted funnel,  or by holding, his head-over  the
mouth of a porringer filled with warm water, Sec.
  Such things as promote the difeharge  of faliva, or caufe the
patient to fpit,  are generally of fervice.  For this purpofe, bitter,
hot, or pungent vegetables may be chewed; as gentian,  calamus
aromaticus,  or pellitory cf Spain.   Allen  recommends  the root
of yelloiv water flour-de-luce in this cafe.  This root may either be
rubbed upon the tooth, or a little  of it chewed.  Brookes fays
he hardly ever knew it fail to eafe the tooth-ach.  It ought how-
ever to be ufed  with caution.
  Many other herbs, roots and feeds, are recommended for cur-
ing the tooth-ach; as the leaves or roots of millefoil  or, yarrow
chewed,  tobacco  fmoked or chewed,  ftaves acre,  or the feeds of
muftard  chewed,  &c.   1 hefe bitter, hot,  and  pungent things,
by occafioning  a greater flow oi faliva,  frequently give eafe in the
tooth-ach.
  Opiates often relieve the tooth-ach.   For this purpofe, a little
cotton wet with laudanum may be held between  the teeth j or a
piece of  tticking-plaifter, about the bigneSs oS a fhilling, with a
bit oS opium in the  middle  oS it,  of  a fize "not to prevent the
fticking of the other, may be laid on the temporal artery, where
the pulfation is moft fenfible.   De  la  Motte affirms,  that there
are few cafes wherein this will not give relief.   If there be a hol-
low  tooth, a fmall pill made of equal  parts of camphire and opi-
um, put into the hollow, is often beneficial.  When this cannot
be had, the hollow tooth may be filled with gum  maftich, wax,
lead, or  any fubftance that will ftick in it, and keep out the ex-
ternal air.
  Few applications give more relief in the tooth-ach than a blifter
applied between  the fhoulders; or rather put behind the ears,
and  made fo large as to cover a great part of the lower jaw.
  When a tooth  is carious,  it is often  impoflible  to remove the
pain without extracting it; and, as a fpoilt tooth never  becomes
found again, it is prudent to draw it foon,  left it fhould affect the
reft.  Tooth-drawing, like bleeding, is verj much practifed  by
mechanics ;  the operation is  not without  danger,  and ought al-
ways to  be  performed with care.   A  perfon unacquainted with
the ftructure of the parts will be in danger of hurting  the jaw-
bone, or of  drawing a found  tooth inftead of a rotten  one *.
  When  the tooth-ach  returns periodically, and the pain chiefly
affects the gums, it may be cured by the bark.
  Some pretend to have found great benefit from the applications
of an artificial magnet.  If it  be found to anfwer, though only in
particular cafes, it certainly dcferves a trial, as it is attended with

  *  This may always be prevented by the operator ftriking upon theS
teeth with any p^e of metal, as this never fails to excite pain in the
carious tooth.
                               K  2 
2c8               THE  EAR-ACH.
no expence,  and no harm.  Electricity has likewife been recom-
mended, and particular instruments have been invented for fend-
ing a fhock through the affected tooth.
  Perfons who have returns of the  tooth-ach at certain feafons,
as fpring and autumn, might often prevent it by taking a purge
at thefe times.
  Keeping the teeth clean tends to prevent the tooth-ach.   The
beft method is to wafh them daily with fait and water, a decoction
of the bark, or with cold water alone.   All brufhing and Scrap-
ing of the teeth  is  dangerous, and  unlefs it be performed with
great care, does mifchief.
                     Of the Ear-Ach.

  THIS diforder chiefly affects the membrane which lines the in-
ner cavity of the ear called the meatus auditorius.  It oSten occa-
fions great reftleffnefs, anxiety, and even delirium. Epileptic fits,
and other convulfive diforders, have been brought on by extreme
pain in the ear.
  The ear-ach  may proceed  from any of the caufes which pro-  ,<
duce inflammation.   It often  proceeds from a fudden fuppreffion
of perfpiration,  or from the head being expofed to cold when co-  -{
vered with fweat;  or from worms, or other infects getting into
the ear, or being bred there ;  or from any hard body flicking in  '
the ear.  Sometimes it proceeds from the tranflation of morbific  I
matter to the ear.   This often happens in the decline of malig-  I
nant fevers,  and occafions deafnefs, which is generally reckoned  j
a favourable fymptom.
  When  the ear-ach proceeds from  infects,  or any hard body
flicking in the ear,  every method muft be taken to remove them
as foon as poffible.  The membranes may be relaxed  by  dropping  '
into the ear, oil of fweet almonds, or olive oil.   Afterwards the
patient fhould be made to  fneeze, by taking fnuff, or fome ftrong
fternutatory.  If this fhould not force out the  body, it muft be
extracted  by  art.   I have feen infects, which had got into the
ear, come out of their own accord upon pouring in oil, which
they cannot bear.
  When the pain of the ear proceeds from inflammation, it muft
be treated like other topical inflammations, by a cooling regimen,
and opening medicines.   Bleeding at the beginning, either in the
arm or jugular  vein, or cupping in the neck, will be proper,  i
The ear may likewife be fomented with Steams of warm  water;
or flannel bags filled with boiled  mallows and  camomile flowers
may be applied  to it warm; or bladders filled with warm milk
and  water.   An  exceeding  good method  of fomenting the 
           P AIN OF THE STOMACH, &c.         2 c9

tar is to apply it clofe to the mouth of a jug filled with warm wa-
ter, or a Strong decoction of camomile-flowers.
   The  patient's feet fhould be  frequently bathed  in lukewarm
water, and he ought to take fmall dofes  of nitre and cream tartar,
half a drachm of  the latter, and ten grains of the former three
times a-day.  His drink may be whey,  or a decoction of barley
and liquorice with figs or raifins. The parts behind the ear ought
Srequently to be rubbed with camphorated oil, or a little of the vo-
latile liniment.
   When the inflammation cannot  be  difcufied, a  poultice of
bread and milk, or roafted onions, may be applied to the ear,  and
frequently renewed, till the abfeefs breaks, or can be opened.  Af-
terwards the humours may be  diverted from the part by gentle
laxatives, blifters, or iffues ; but the difeharge muft not be  Sud-
denly dried up by any external application.
                 Pain of the Stomach,  csV.

  THIS may proceed from various caufes ; as indigeftiom ; wind j
the acrimony of the bile ; (harp, acrid, or poifonous fubftances ta-
ken into the ftomach, &c.  It may likewife  be occafioned  by
worms ; the ftoppage  of cuftomary evacuations; a tranflation of
gouty matter to the ftomach, the bowels, &c.
  Women in the decline of life are very liable to  pains of the fto-
mach and bowels, efpecially  fuch as are afflicted with hyfteric
Complaints.  It is likewife very common  to hypochondriac men of
a fedentary and luxurious, life.  In fuch perfons, it often proves fo
extremely obftinate as to baffle medicine.
  When the pain of the ftomach is moft violent after eating, there
is reafon to  fufpect that it proceeds from fome fault either in the
digeftion or  the food.  In this cafe, the patient ought to change his
diet, till he finds what kind of food agrees beft with his ftomach,
and fhould continue chiefly  to ufe it. If a  change of diet does not
remove the complaint, the patient may  take a  gentle vomit, and
afterwards a dofe or two of rhubarb. He ought  likewife to take
an infufion of camomile flowers,  or fome other ftomachic bitter,
either in wine or water.  I have often known exercife remove this
complaint, efpecially failing, or a long  journey on horfeback, or
in a carriage.
  When a pain of the ftomach proceeds from  flatulency, the pa-
tient  is conftantly belching up wind, and feels an uneafy  diften-
tion of the ftomach after meals. This  is the rnoft  deplorable dif-
eafe, and is feldom thoroughly cured. In general, the patient ought
to avoid all windy diet, and every thing that fours on the ftomach,
as green6, roots, &c.  This rule admits  of fome  exceptions. Ma- 
*6o        PAIN OF THE STOMACH, &c.
 ny perfons very much foubled with wind, have received great he-.
 nefit from eating parched peafe, though that grain  is generally.
 fuppofed to be of a windy nature*.
    i his complaint may likewife be greatly relieved by labour, ef-
 pecially digging, reaping, mowing, or any kind of active employ-
 ment by which the bowels are alternately compreffed and dilated.
 The moft obftinate caSe oS this kind I ever met with, was in a per-
 fon oS a Sedentary occupation, whom I adviSed, aSter  he had tried
 every kind oS medicine in vain, to turn gardener ; which he  did,
 and has ever fince enjoyed good health.
   When a pain of the ftomach is occafioned  by the fwallowing
 of  acrid,or  poifonous fubftances, they muft be difcharged by vo-
 mit ; this may  be  excited by butter, oils, or other  foft things,
 which fheath and deSend the  ftomach Srom the acrimony oS its
 Contents.
   When a pain of the ftomach proceeds from a tranflation of gouty
 matter, warm cordials are neceffary,  as  generous wines,  French
 branny, Sec. Some in this cafe have drank a whole bottle oS bran-
 dy  or rum  in a Sew  hours,  without being  in the leaft intoxica-
 ted, or even  Seeling the ftomach warmed  by it. It is impoflible to
 aScertain the quantities neceffary upon thefe occafions. This muft
 be  left to the feelings and discretion oS the patient. The SaSer way,
 however, is, not to go too Sar.  When there  is an inclination to
 vomit, it may  be promoted by drinking an inSufion  of camomile
 flowers, or carduus benediclus.
   IS a pain of the ftomach proceeds from  the ftoppage of cuftoma-
 ry  evacuations, bleeding  will be necefiary, eSpecially in Sanguine
 and very Sull habits.  It will likewiSe  be of ufe to keep the body
 gently open by mild purgatives;  as caftor oil, fenna,  &c. When
 this difeafe affeas women, in the decline of life, after the ftop-
 page of the menfes, making an iflue in the leg or arm will be of pe-
 culiar fervice.
  When the difeafe is occafioned by worms, they muft be deftroy-
 ed, or expelled by means recommended in the following fedtion:
   When the ftomach is greatly  relaxed, and the digeftion bad,
 which often occafion flatulencies, the elixir of vitriol will be of
 lingular fervice.  Fifteen or twenty drops of it may be taken in a
glafs of wine or water twice or thrice  a-day.
  Perfons afflicted with flatulency are generally unhappy unlefs
they be taking Some purgative medicines  ; thefe, though they may
 give immediate eafe, weaken and relax  the ftomach  and  bowels,
and consequently increafe the diSorder.  Their beft method is to
mix purgatives and ftomachics together.  Equal parts  oS bark and
rhubarb may be infufed in brandy,or wine, and taken in fuch quan-
 tity as to keep  the body gently open. 
T   261   ]
              CHAPTER   XXXVII.

                         Of Worms.

      THESE are chiefly of three kinds, viz. the tenia, or tape-
       worm ; the teres,  or round  and long worm ; and the afca-
 rides, or round or fhort worm. There  are many other kinds of
 worms found in the human body ; but as they proceed, in a great
 meafure, from fimilar cauSes, have nearly the Same Symptoms, and
 require almoft the Same method of treatment as theSe already men-
 tioned, we Shall not Spend time in enumerating  them.
    The tape-worm is white,very long, and Sull oS joints.  It is ge-
 nerally bred either in the ftomach or Small inteftines.. The round
 and long worm is likewiSe bred in the Small guts, and Sometimes in
 the ftomach. The rouiid and fhort worms commonly lodge in the
 rectum,  or what is called the end gut, and occafion a diSagreeable
 itching about the Seat.
    The long round worms occafion SqueamifhneSs, vomiting, a dif-
 agreeable breath,  gripes, loofenefs, Swelling of the belly,  fwoon-
 ings, loathing of food,  and  at other times a voracious appetite, a
 dry cough, convulfions, epileptic fits, and Sometimes  a privation
 ' oS Speech. TheSe worms have been known  to perSorate the intef-
 tines, and get into the cavity oS the belly. The effects oS the tape-
 worm are nearly the Same with thoSe of the long and round," but
 rather more violent.
    Andry fays, the following fymptoms particularly attend the^,
 Hum, which is a fpecies of the tape-worm, viz. fwoonings, priva-
 tion of fpeech and a voracious appetite. The round worms called
 afcarides, befides an itching of the anus, caufe fwoonings,  and te-
 nefmus, or an inclination to go to ftool.
    CAUSES.----Worms may proceed from various caufes, but
* ftiey are feldom found except in relaxed ftomachs, where the di-
 geftion is bad. Sedentary perSons are more liable to them than the
 active and laborious. ThoSe who eat great quantities  oS  unripe
 fruit, or who live much on raw herbs and foots, are generally Sub-
 ject to worms.  There Seems to be a hereditary diSpofition in Some
 perSons to this diSeaSe.  I have often feen all the children of a fami-
 ly fubject to worms of a particular kind. They feem likewife fre-
  quently to be owing to the nurfe. Children of  the fame  family,
  nurfed by one woman, have often worms,  when thofe  nurfed by
  another have none.
    SYMPTOMS----The common  fymptoms of worms  are,
  palenefs of the  countenance, 3nd at other times, an univerfal
  flufhing of the face ; itching of the nofe ;  this however is doubt-
 ful, as children pick their nofes in all difeafes; ftarting, and'grind-
 ing of the teeth in fleep ; fwelling of the upper lip ; the appetite 
2<52                  OF  WORMS.
fometimesbad, at other times quite voracious; loofenefs ; a four or
ftinking  breath;  a  hard fwelled  belly;  great  thirft ;  the urine
frothy,  and fometimes  of a whitifh colour;  griping, or colic
pains; an involuntary difeharge oi faliva, efpecially when afleep;
frequent pains of the fide, with a dry cough, and unequal pulfe;
palpitations of the heart; fwoonings; drowfinefs; cold Sweats;
palfy; epileptic fits, with  many other  unaccountable  nervous
fymptoms, which were  formerly  attributed to witchcraft, or the
influence of evil  fpirits. Small bodies in the excrements refem-
bling melon or cucumber feeds are fymptoms of the tape-worm.
   I lately faw fome very furprifing effects of worms in  a girl a-
bout five years of age, who ufed to lie for whole hours as if dead.
She at laft expired, and, upon opening her body, a number of the
teres,  or long round worms, were found in her guts, which were
confiderably inflamed ; and what  anatomifts call an intus fufceptio,
or involving of one part of the gut  within another, had taken
place in no lefs than four different parts of the inteftinal canal.*
  MEDICINE.----Though numberlefs medicines are extolled for
expelling and killing  worms,f yet no difeafe  more  frequently
baffles the phyfician's fkill. In general, the moft proper medicines
for their expulfion are  ftrong purgatives;  and to prevent their
breeding,  ftomachic bitters, with now and then  a glafs of good
wine.
   'i he beft purge  for an adult is  jalap and  calomel. Five and
twenty or thirty grains of the former with fix or feven  of the lat-
ter, mixed in Syrup, may  be taken early in the  morning, for a
dofe.  It will be proper that the patient keep the houfe all day, and
drink nothing cold.  The dofe may be repeated once or twice a
week, for a fortnight or three weeks.  On the intermediate days,
the patient may take a drachm of the powder of tin, twice or thrice
a-day, mixed with fyrup or honey.
   Thofe who do not chufe to take calomel may make ufe of the
bitter purgatives; as aloes, hiera picra,  tincture of fenna, and
rhubarb, &c.
   Oily  medicines are fometimes  found beneficial for expelling
worms. An ounce of fallad oil and a table-fpoonful of common
fait may be taken in a glafs of red port wine thrice a-day or often-
er, if  the ftomach will bear it.  But the  more  common fojjpi of
ufing oil is  in clyfters. Oily clyfters Sweetened with Sugar or  ho-
  * That worms exift in the human body, there can be no doubt;  and
that they muft fometimes be confidered as a difeafe, is equally certain :
but this is not the cafe fo often as people imagine.  The idea that worms
occafion many difeafes, gives an opportunity to the profefTed worm-
doctors of impofingon the credulity  of mankind,  and doing much mif-
chief.  They find worms in every cafe, and liberally throw in their an-
tidotes,  which generally confift of ftrong draftic purges:  I have known
thefe given in delicate conftitutions to the deftru&ion of the patient,
where there was not the leaft fymptom of worms.
  t A medical writer, of the prefent age, has enumerated upwards of
ifty Britifli plain.-, all celebrated for killing and expelling worms. 
                      OF WORMS.                  263

ney, are very efficacious in bringing away the (hort round worms
called afcaridcs, and likewiSe the teres.
  The Harrowgate water is an excellent medicine for expelling
worms, efpecially the afcarides. As this water is impregnated with
fulphur, we may hence inSer, that Sulphur alone muft be a good
medicine in this caSe;  which is found to be a fact.  Many prac-
titioners give flour of fulphur in very large dofes, and with great
fuccefs. It fliould be made into an electuary with honey or treacle,
and taken in fuch quantity as to purge the patient.
  Where Harrowgate water cannot be obtained, fea-water may be
ufed.  If  fea-water cannot be had, common fait diffolved in wa-
ter may be drank.  I have often feen this ufed by country nurfes
with very good effect.  Some flour of fulphur may be taken over
night, and the falt-water in the morning.
   But worms, though  expelled, will foon breed again, if the fto-
mach remains weak and relaxed ;  to prevent which, we would re-
commend  the bark. Half a drachm of bark in powder may be
 taken in a glafs of red  Port wine three or four times a-day, after
 the above medicines have been ufed. Lime-water is likewife good
 for this purpofe, or a table-fpoonful of the chalybeate wine taken
twice or thrice a-day.  Infufions or decoctions of bitter herbs may
likewife be drank;  as the infufions of tanfy, water trefoil, camo-
 mile-flowers, tops of wormwood, the leffer centaury,  &c.
   For a child of Sour or five years old, fix grains of rhubarb, five
oS jalap, and two of calomel, may be mixed in a fpoonful of fyrup
or honey,  and given in the morning.  The child fhould keep the
houfe all day, and take nothing cold.  This dofe may be repeated
 twice a-week for three or four weeks. On the intermediate days,
the  child may take a  Scruple of powdered  tin, and ten grains of
aethiops mineral in a fpoonful of treacle twice a-day.  This dofe
 muft be increafed or diminifhed according to the age of the pa-
tient.
   Biflet fays, the great baftard black hellebore,  or bear s foot, is a
 moft powerful vermifuge for  the long  round worms.   He orders
the  decoction of about a drachm of the green leaves, or about fif-
 teen grains of the dried leaves in powder, for a dofe to a child be-
 tween four and  feven  years of age.  This  dofe is to be repeated
 two or three times.  He adds, that the green leaves, made into a
 fyrujf, with coarfe Sugar, is almoft the only medicine he has uSed
 for round  worms Sor three years  paft.  BeSore preffing out the
juice, he moiftens the bruiSed leaves with vinegar,  which corrects
 the medicine. The doSe is  a  tea-SpoonSul at bed-time, and one or
 two next morning.
   I have frequently known thefe big bellies, which in children are
 commonly reckoned a fign of worms, quite  removed,  by giving
 them white foap in their pottage, or other food. Tanfy, garlic, and
 rue, are all againft worms, and may be ufed various ways.   We
 might here mention many other  plants, both for external and ia.- 
264                THE  JAUNDICE.
ternal ufe, as the cabbage-bark, &c. but think the powder of tin,
and the spurges cf jalap and calomel, are more to be depended on.
   Ball's "purging vermifuge powder is a very powerful medicir.e.
It is made of equal parts of rhubarb, feammony, and calomel,
with as much double-refined fugar as is equal to the weight of all
the other ingredients. Thefe muft be well mixed together, and re-
duced to a fine powder.   The dofe for a child, is from ten grains
to twenty, once  or twice a-week.  An adult may take a drachm
for a dole*.
   Parents, who  would  preferve their children from worms, ought
to allow them plenty of exercife in the open  air ; to take care that
their food be  wholefome and  fufficiently folid ; and as far as pof-
fible, to prevent their eating raw herbs, roots, or green trafhy fruits.
It will not be amifs to allow a child  who is fubject to worms, a
glafs oS red wine aSter  meals; as every thing that  braces and
ftrengthens the ftomach, is good both for  preventing and expel-
ling thefe verminf.
             CHAPTER   XXXVIII.


                       Of the faundice.

     THIS difeafe is firft obfervable in the white of the eye, which
      appears yellow. ASterwards the whole fkin puts on a yellow
 appearance.  The urine too is oS a Saffron hue, and dies a white
 cloth oS the Same colour.   There is likewiSe a  Species oS this dif-
 eafe called the black jaundice.
   CAUSES-----The immediate caufe of the  jaundice is an ob-
 struction of the bile. The remote or occafional cauSes are, the bites
 oS poifonous  animals, as  the viper, mad dog,  Sec. the bilious or
 hyfteric colic;  violent paffions, as grieS, anger, &c.   Strong pur-
 ges or vomits will  likewiSe occafion the jaundice.  Sometimes it
 proceeds Srom obftinate agues, or Srom that diSeaSe being prema-
 turely ftopped by aftringent medicines. In infants, it is often occa-

    A powder.for the tape-worm refembling this was long kept aftcret
 on the continent; it was lately pur chafed by the French King, and will
 be found under the article Powder,  in the Appendix.
  t It is neceffary to warn people of their danger who buy cakes, pow-
ders, and other worm med^ues, at random,  from quacks, and give
them to their children without proper care.  The principal  ingredient
in moft  of thefe  med.on.e,, is mercury, which  is  never  to be trifled
Zr\ ™I  l  1 ?r 3 lnOC}'?& i"ltant'e ot'the '^nger of this conduct.  A
girl who had  taken a dofe  ot worm powder, bought -of a travelling
3!nn;£ent°Ut,-    <fvfrhapS 'T fo,iniPr,ldent as  to drink  cold wat«
 nTdaV wiS'Sl'T f    »»ine^te,ly twed.d, and died on the follow-
ing day, with all the fymptoms of having been poifoncd. 
THE  JAUNDICE.               265
fioned by the meconium not being fufficiently purged off. Pregnant
women are very Subject to it. It is likewiSe a Symptom in Several
kinds of fever.  Catching cold, or  the ftoppage of cuftomary eva-
cuations, as the rnenfes, the  piles, iffues,  &c will occafion the
jaundice.
   SYMPTOMS.-;---The patient at firft complains of exceffive
wearinefs, and  has great averfion to  every kind of motion.  His
fkin is dry,  and he generally feels a kind of itching or pricking
pain over the whole body. The  ftools are of a whitifh or clay co-
lour, and the urine, as was obferved above, is yellow. The breath-
ing is difficult,  and the patient  complains of  an unuSual load or
oppreffion on his breaft. There is a heat in the noftrils, a bitter
tafte in the mouth, loathing of food, ficknefs  at the ftomach, vo-
miting, flatulency, and other Symptoms of indigeftion.
   If the patient be young,  and the difeafe complicated with no
other malady,  it is feldom dangerous ; but in old people, where
it continues long, returns frequently, or is complicated with the
dropSy, or hypochondriac fymptoms, it generally proves fatal.
   REGIMEN.----The diet fhould be cool, light,  and diluting,
confifting chiefly of  ripe fruits and mild vegetables; as apples
boiled or roafted, ftewed prunes, preServed plumbs, boiled Spinage,
Sec Vfeal or chicken-broth, with light bread, are likewiSe very pro-
per.  Many have been cured by living almoft wholly for fome days
on raw eggs.  The drink fliould be butter-milk, whey fweetened
with honey, or decoctions of cool opening vegetables;  or marfli-
mallow roots, with liquorice, Sec.
   The patient fhould take as much exerciSe as he can bear, either
on horfeback, or in a carriage ; walking, running, and even jump-
ing, are likewife proper, provided  he can bear  them without pain,
and there be no fymptoms of inflammation.   Patients have been
often cured of this difeafe by a long jpurney, after medicines had
proved  ineffectual.
   Amufements are likewife of great ufe in the jaundice. The dif-
eafe is often occafioned by a  Sedentary liSe, joined to  a dull me-
lancholy diSpofition.  Whatever therefore  tends to promote the
circulation, and to cheer the fpirits, muft have a good  effect; as
dancing, laughing, finging, &c
   MEDICINE.----IS the patient be young, of a full Sanguine
habit, and complains of pain in  the right fide about the region of
the liver, bleeding will be neceffary.  After this a vomit  muft be
adminiftered, and  if  the difeafe  proves obftinate,  it may be re-
peated once or twice.  No medicines are more beneficial in the
jaundice than vomits,  efpecially  where it is not attended with in-
flammation.  Half a drachm of ipecacuanha  in powder will be a
fufficient dofe  for  an  adult.  It may be wrought off with weak
camomile-tea, or lukewarm water.  The body muft likewife be
kept open by taking a fufficient quantity of Caftile foap, or the
pills for  the jaundice recommended in the appendix. 
266                THE DROPSY.
   Fomenting the parts about the region of the ftomach and liver,
and rubbing them  with a warm hand or flefh-brufh, are likewife
beneficial; but it is ltill more fo  for the patient to fit in a bath
of warm water up  to the breaft.  He ought to do this frequently,
and fhould continue in it as long as his ftrength will permit. x
   Many dirty things are recommended for the cure of the jaun-
dice ; as lice, millepedes, &c  But thefe do more harm than good,
as people truft to them, and neglect' more valuable medicines;
befides, they are feldom  taken in  fufficient quantity to produce
any effects. People always expect  that fuch things  fliould act as
charms, and confequently feldom perfiit in the ufe of them. Vo-
mits, purges, fomentations, and exercife, will feldom fail to cure
the jaundice when it is a  fimple difeafe ; and when complicated
with the dropfy, a fehirrous liver, or other chronic complaints, it
is hardly to be cured by any means.
  Numberlefs Britiih herbs are extolled for the cure of this dif-
eafe. The author of the Medicina Britannica mentions near a hun-
dred, all famous for curing the jaundice. The difeafe often goes
off of its own accord; in which cafe,  the laft medicine is  always
faid to have performed the cure. I have feen confiderable benefit,
in a very obftinate jaundice, from a decoction of hempfeed. Four
ounces of the feed may be  boiled in two Englifh quarts of ale, and
fweetened with  coarfe fugar.   The dofe is half an Englifh pint
every morning. It may be continued for eight or nine days.
  I have likewife known Harrowgate fulphur water cure a jaun-
dice of very long ftanding.  It fliould be ufed for fome weeks, and
the patient both drink and bathe.
  The foluble tartar is a  very  proper  medicine in  the jaundice.
A drachm of it may be taken every night and  morning in a cup of
tea or water-gruel. If it does not open the body, the dofe may be
increafed.  A very obftinate jaundice has betn cured by  fwallow-
ing raw eggs.
  Perfons fubject to the jaundice ought to take as much exerciSe
as poffible, and to avoid all heating and aftringent aliments.
             CHAPTER   XXXIX.

                   ^  Of the Dropfy.                ,

     THE dropfy is a preternatural fwelling of the whole body, or
      fome part oS it, occafioned by a collection oS watery humour.
It is diltingufhed by different names, according to the part affec-
ted, as the anafarca, or a collection of water under  the fkin ;  the
afcites, or a collection of water in the belly ; the hydrops petloris, or
dropfy of the breaft ; the hydrocephalus, or dropfy of  the brain, k. 
THE  DROPSY.               ,  267
   CAUSES-----The dropfy is often owing to an hereditary dif-
pofition.  It may proceed from drinking ardent  fpirits, or other
Strong liquors. It is true almoft to a proverb, that, great drinkers
die of a dropSy.  Hence it is juftly reckoned among the diSeaSes oS
the Sedentary. It oSten proceeds  Srom exceffive  evacuations, as
frequent and copious  bleedings, ftrong purges often repeated, fre-
quent- Salivations, &c. The Sudden  ftoppage of cuftomary or ne-
ceffary evacuations, as the  menfes, the haemorrhoids, fluxes of the
belly, &c. may likewife caufe a dropfy.
   I have known the dropfy occafioned by drinking large  quantities
of cold, weak, watery liquor, when the  body was heated by vio-
lent exercife,.  A low,  damp, or marfhy fituation is likewiSe a fre-
quent caufe oS it. Hence it is a common diSeaSe in moift, flat, iew-
uy countries. It may  alSo  be brought on by a long uSe oS.poor
watery diet, or oS viScous aliment that is hard of digeftion. It is
often the effect  of other difeafes,  as the jaundice,  a fchirrus of
the liver, a violent ague of long continuance, .: diarrhoea, a dyfen-
tery, an empyema, or a confumption of the lungs. In fhort, what-
ever obftructs the perfpiration, or prevents the blood Srom being
duly prepared, may occafion a dropSy.
   SYMPTOMS-----The  anafarca generally begins  with a Swel-
ling oS the Seef and ancles towards night, which Sor Some time dis-
appears in the morning.  In the evening, the parts, iS preffed with,
the finger, will pit.  The Swelling gradually aScends,  and occupies
the trunk oS the body, the arms  and the head.  Afterwards the
breathing becomes difficult, the urine is in fmall quantity, and the
thirft great;  the body is bound,  and the perfpiration  is greatly
obstructed.  To theSe Succeed torpor, heavincSs, a  flow wafting
Sever, and a troublefome cough. This laft is generally a Satal Symp-
tom, as it fhows that the lungs are affected.
   In an afcites,  befides the  above Symptoms, there is  a Swelling of
the belly, and often a fluctuation,  which may be perceived by
ftriking the belly on  one fide, and laying the palm oS the hand
on the oppofite.  This may be diftinguifhed Srom  a tympany by the
weight'oS the Swelling, as  well as by the fluctuation. When the
anrfarca and afcites are combined, the caSe is very dangerous. Even
a Simple afcites Seldom admits of a radical cure.  Almoft all that
can be done is, to let off the water hy tapping, which Seldom af-
fords more than a temporary relief.
   When the difeafe comes Suddenly on, and the  patient is young
and ftrong, there is reafon however to hope Sor a  cure,  eSpecially
if medicine  be given early. But if the patient be old, has led an
irregular or a Sedentary life,' or iS there be reaSon to SuSpect that
the liver, lungs, or any oS the viSccra are unSound, there is great
ground to Sear that the conSequences will prove Satal.
   REGIMEX.----The patient muft abftain, as much as poffible,
from all drink, eSpecially weak and watery liquors, and muft quench
his thirft with muftard-whey, cr acids, as juiee of!..no;;*,oranges, 
C68                THE DROPSY.
 Sorrel, or Such like.   His aliment ought to be dry, of a ftimulat-
 ing diuretic quality,  as toafted bread, the flefh of birds, or othe*
 wild animals roafted ; pungent and aromatic vegetables, as gar-
 lic; muftard, onions, creffes, horSe-radifh, rocambole. Slialot, &c.
 He may alSo eat Sea-biScuit dipt in wine or a little brandy.  This
 is not only nourishing but tends  to  quench  thirft.   Some have
 been actually cured of" a dropfy by a total abftinence from all li-
 quids, and living entirely upon fuch things as are mentioned above.
 If the patient muft have drink, the Spa-water, or Rhenifh wine,
 with diuretic  medicines infufed in it, are the beft.
   Exercife is of the  greateft  importance in a dropfy.  If the pa-
 tient be  able to walk, dig, or the like, he ought to continue thefe
 exercifes as long as he can.   If he is not able to walk  or  labour,
 he muft ride on horfeback, or in a carriage, and the more violent
 the motion, fo much the better, provided he can bear it. His bed
 ought to be  hard, and the air of his apartments warm and dry.
 If he lives in a damp country, he ought to be removed into a dry
 one, and, if poffible, into a warmer  climate. • In  a  word, every
 method fliould be taken to promote the  perfpiration, and to brace
 the Solids.   For this purpofe it will likewiSe be proper to rub  the
 patient's body, two or three times a-day, with a hard cloth, or the
 flefh-brufh; and he ou: he conftantly to wear flannel next his fkin.
   MEDICINE.----If  the  patient be  young,  his conftitution
-good, and the diSeaSehas come on Suddenly, it may generally be
 removed by ftrong vomits, brilk purges, and  Such medicines as
 promote a diScharge by Sweat and urine.r  For an adult, half a
 drachm  of ipecacuanha in powder, and half an ounce of oyxmel
 of Squills, will be a proper vomit. This may be repeated  as often
 as neceffary, three or four days intervening between the doSes.
 The patient muft not drink  much aSter taking the vomit, other-
 wise he deftroys its effect. A cup or two of camomile-tea will be
 fufficient to work it  off.
   Between each vomit  on one of the intermediate days, the pa-
 tient may take the  following  purge: Jalap in'powder, half  a
 drachm, cream of tartar, two drachms, calomel, fix grains. 1 hefe
 may be  made into a bolus with a little fyrup of pale rofes, and  ta-
 ken early in the morning.  The lefs  the patient drinks after it the
 better. If he be much griped, he may take now and then a  cup
 of chicken-broth.
   The patient may  likewife take every night at bed-time the fol-
 lowing bolus : To four or  five grains of camphor add one grain

    Anafarca in young people has fometimes been cured by bleedinc
 w;icn the puife has been full and ftrong; but ill afcites, which  moft ge-
 nerally comes on at  an advanced period of life, when theconiUuiicn is
 ponuderably impaired, frequently by an irregular mode of life, bleed-
 ing appears to be improper, and even in afcites,  when  the parent
 h-is been young, I have feen this evacuation ufed early w -h  marilct
 fhiadvamage.                            ' (I. C.) 
THE  DROPSY.                 269
of opium, and as much fyrup  of orange-peel as is fufficient to
make them  into a bolus. Tins will generally  promote a gentle
fweat, which  fliould be encouraged by drinking now and  then
a Small cup of wine-whey, with a tea-fpoonful  of  the fpirits of
hartfliorn in it. A tea-cupful of the following  diuretic  infufion
may likewife  be taken every four or five hours  through the day :
   Take juniper berries, muftard-feed, and horSe-radifn,  of each
halS an ounce, afhes  of broom half a pound  ; infufe  them in a
quart of Rhenifh wine or ftrong ale for a few days, and afterwards
Strain off the liquor.  Such as cannot take this inSufion, may ufe
the decoction of feneka-root, which is both diuretic and fudorific.
I have known an obftinate anafarca cured  by an infufion of the
afhes of broom in wine.
   The above courfe will often cure an incidental  dropfy, if the
conftitution be good ; but when the difeafe proceeds  from  a bad
habit, or an unfound ftate of the vifcera, mercury fhould be ufed ;
and at the  fame time the ftrength fupported by warm and nou-
rifhing cordials.
   The fecretion  of urine  may be greatly  fupported by  nitre.
Brooke's fays, he knew  a young woman who was cured of a  drop-
fy by taking a drachm oS nitre every morning in a draught of ale,
aSter fhe had been given over as incurable.  The powder oS Squills
is likewiSe a good diuretic.  Six or  eight grains oS  it, with a Scru-
ple oS nitre,  may be given twice a-day in a glaSs of ftrong cinna-
mon-water. Ball fays,  a large fpoonful of unbruifed muftard-feed
taken every night and morning, and drinking half an Englifh pint
of the decoction of the tops of green broom after it, has perform-
ed a cure after other -powerful medicines had proved ineffectual.
   I have fometimes feen good effects from cream of tartar in this
 difeafe.  It promotes the difcharges by ftool and urine, and will at
leaft palliate, if it does not perform a cure.  The patient may be-
gin by taking an ounce every  fecond or third  day, and  may in-
creafe the quantity to two or even to three ounces, 'S. the ftomach
wili bear it.  This quantity is not however to be taken at once,
 but divided into three or four dofes.
   To promote perSpiration, the patient may uSe the decoction  of
 feneka-root, as directed above; or he may take two table-fpoen-
 Suls oS Mindererus's Spirit in a cup oS  wine-whey three or Sour
 times a-day. To promote a diScharge of urine, the  following infu-
 fion of the London hofpitals will likewife  be beneficial:
   Take of zedoary-root  two drachms ;  dried fquills,  rhubarb,
 and juniper-berries bruifed,  of each a drachm; cinnamon in pow-
 der, three drachms ;  fait of worm-wood, a drachm and a half;
infufe in an Englifh pint and a half of old hock-wine,  and when fit
 for ufe, filter the liquor.  A wine-glaSs cf it may he taken three
 or four times a-day.
   In the anafarca it is ufual to Scarify the feec and legs.   By this
 psans, the- water is cfcaei difcharged 5 but  the operator nw.il  be 
2"0
THE  GOUT.
cautious not to make the incifions too deep : they  ought barely to
pierce through the fkin, and eSpecial care muft  be taken, by Spi-
rituous Somentations  and  proper digeftives, to prevent a  gan-
grene.
   In an afcites, when the diSeaSe does not evidently  and Speedily
give way to purgative and diuretic medicines, the water ought to
be let off by tapping.   This  is a very Simple and SaSe operation,
and would oSten Succeed if it were performed in due time, before
the fyftem become too much  debilitated.*
   After the evacuation of the water, the patient is to be put  on
a courfe of ftrengthening  medicines ; as the bark ; the elixir of
vitriol; warm aromatics, with a due proportion  of rhubarb,  in-
fufed in wine, and fuch like.  His diet ought to be dry and nou-
rifhing, fuch as is recommended in the beginning of the chapter;
and he fliould take as much exercife as he can bear  without  fa-
tigue..  He fhould wear flannel nc:.t his Ikin, and daily ufe the
flefh-brufh.
                 C  H A P T E  R   XL.

                         Of the Gout.

 Ik TO difeafe fhbws the imperfection of medicine, or fets the ad-
 |_^ vantages of temperance and exercife in a  Stronger light,
 than the gout.  Excefs and idlenefs  are  the true Sources  Srom
 whence it originally Sprung, and  all who wxiuld avoid it muft be
 atlive and temperate.
   Though idleneSs and intemperance are the principal  cauSes of
 the gout,  yet  many other things  may contribute to bring on the
 diforder in thofe who are not,  and  to induce a  paroxyfm in thoSe
 who are Subject to it; as intenSe ftudy ;  too Sree an uSe oS acidu-
 lated liquors ; night-watching ;  grief or unealineSs oS mind ; an
 obstruction or defect of any of the cuftomary difcharges, as the
 menfes, fweatinir of the feet, perfpiration, &c.
   SYMPTOMS.----A fit is generally preceded by indigeftion,
 drcwfineSs, belching  of  wind, a flight  head-ach, ficknefs,  and
 fometimes vomiting.  The patient complains oS wearineSs  and
 dejection  oS Spirits, and has oSten a pain  in the limbs, with a fen-
 fation as if wind or cold water were pairing down the thigh. 1 he

  * The very name of an operat'on is dreadful to moft people, and
they <viih to try every thing before they have recomfeto it. Tifisisthe
reafon \v!:v tapping fo feldom fucceeds  t* our wifh.  1 have had a patient
who wa-, regularly tapped once a month fur feveral years, and who ufed
to e..t her dinner as well after the operation, as if nothing had happen
 ed. ^i;«r dird at laft rather won;  out by age than by the difeafe. 
THE  GOUT.
 appetite is often remarkably keen a day or two before the fit, and
there is a flight pain in paffing urine, and fometimes an involun-
tary Shedding of tears. Sometimes thefe fymptoms are much more
violent, efpecially upon the near approach of a fit ; and fome ob-
ferve, that as is the  fever which uihers in the gout, fo  will the fit
be ; if the fever be fhort and lharp,  the fit will be fo likewife, if
it be feeble, long, and lingering, the fit  will be fuch  alfo.  But
this obfervation can only hold  with refpect to  very regular fits of
 the gout.
  The regular gout generally makes its attack in the fpring, or be-
ginning of winter, in the following  manner : About two or three
in the morning, the patient is feized with a pain in his great toe,
fometimes the heel, and at other times in the ancle or  calf oS the
leg.  This pain is accompanied with a SenSation as if cold water
were  poured upon  the part, which is fucceeded by a fhivering,
with fome degree of fever.  Afterwards the pain increafes, and
fixing among the fmall bones of the foot, the patient feels ail the
different kinds of torture, as if the part were  ftretched, burnt,
fqueezed, gnawed, or torn in pieces, Sec, The part at length be-
comes fo exquilitely fenfible, that the patient cannot bear to have
 it touched, or even  Suffer any perSon to walk acroSs the room.
  The patient is generally  in  exquifi'.e  torture Sor  twenty-Sour
hours, Srom the time oSthe coming on oSthe fit: he then  becomes
eafier, the part begins to Swell, appears red, and is covered  with
a little moifture. Towards morning he drops afleep, and generally
falls into a gentle breathing fweat.   This terminates the firft pa-
roxySm, a number of  which constitutes a fit oS the gout; which
is longer or  fhorter  according to the  patient's age, ftrength, the
feaSon of the ye\ir, and the difpofition of the body to this difeafe.
  The patient  is always worfe towards  night, and eafier in the
morning.  The paroxyfms generally grow milder every  day, till at
length the difeafe is carried off by  perfpiration, urine,  and the
other evacuations. In fome patients, a few days; in others, weeks,
 and in fome, months are required to finifh the fit.   Thofe whom
 age and frequent fits of the gout have greatly  debilitated, feldom
 get free from it before ihj approach of fummer, and  fometimes
 not till it.be pretty far advanced.
  "REGIMEN.----No medicines yet known will cure the gout;
 we fhall confine our obfervations chiefly to regimen,  both in and
out of the fit.
   In the fit, if the  patient be young and ftrong, his diet ought to
 be thin  and  cooling, and his drink of a diluting nature ; but where
 the conftitution is weak, and the patient has been accuftomed to
 live high, this  is not a proper  time to retrench.  In this cafe, he
 mult keep n.arly to his ufu.al diet,  and  fhould take frequently a
 cup of ftrong negus, or a glafs of generous wine.  Wine-whey is
a very proper drink in this cafe, as  it promotes the perfpiration
without £rca'-ly heating the pa'.iciu.  It  will anfwer this purpofe 
272
THE  GOUT.
better, if a tea-fpoonful  offal volatile oleofum, or fpirits of hartf-
liorn, be put into a cup of  it twice a-day. It will likewife be pro-
per, to give at bed-time,  a tea-fpoonful of the  volatile tincture of
guaiacum in a large draught of warm wine-whey. This will great-
ly promote perfpiration through the night.
   As the molt fafe and efficacious method of difeharging the gou-
ty matter is by perfpiration, this ought to be kept up by all means,
efpecially in the affected  part. For this purpofe, the leg and foot
fhould be wrapt in flannel, fur, or wool.  The laft feems to anfwer
the purpofe better than any thing elfe.  The people of Lancafhire
look upon wool as a kind of  fpecific in the gout.   They wrap a
great quantity of it about the leg and foot affected, and cover it
with a fkin of foft dreffed leather.  This  they Suffer to continue
Sor eight or ten  days,  and Sometimes  for  a  fortnight or  three
weeks, or longer, iS the pain does not ceaSe. I never knew any ex*
ternal application anSwer So well in the gout.   I have often Seen
it applied when the Swelling and inflammation were very great,
with violent pain,  and have Sound all theSe Symptoms relieved by
it in a Sew days.  The wool is generally greafed, and carded or
combed. They chooSe  ihe SoSteft which can be had, and Seldom'
or never remove it till the fit be entirely gone  off.
  The patient ought to be kept quiet and eafy  during the fit. Eve-
ry thing that affects the mind difturbs the paroxySm, and tends to
throw ihe gout upon the  nobler parts.   All external applications
that repel the matter are to be avoided as death. They do not cure
the diSeaSe, but remove it Srom  a SaSer to a more  dangerous part
oS the body, where it often proves Satal.  A fit oS the gout is Na-
ture's method of removing fomething that might  prove diftruc-
tive to the  body, arid all  that we can do, with SaSety, is to promote
her intentions, and affift  her in  expelling the enemy in her own
way. Evacuations  by bleeding, ftool, &c. are likewiSe to be uSed
with caution ; they do not remove the  cauSe of the diSeaSe, and
"Sometimes by weakening  the  patient, prolong the fit: but, where
the conftitution is able to bear it, it will be of uSe to keep the bo-
dy gently open by  diet,  or even mild laxative medicines.
   Many things will indeed  Shorten a  fit of the gout, and fome
will drive it off altogether ;  but nothing has yet been found which
v. ill do this with fafety to the patient.  In pain, we eagerly grafp
at any thing that promifes immediate eafe, and even hazard life
itfelf for a temporary relief.  This is the true reafon why fo many
infallible remedies  have  been propofed  for the gout, and  why
fuch numbers have loft their lives by the ufe of them. It would be
as prudent to ftop the fmall-pox from rifing, and to drive them in-
to the blood, as to  attempt to  repel the gouty matter aSter it has
been tl rown upon the extremities.   The1 latter is  as much an ef-
fort of Nature to free herfalf Sr^.i an offending caufe as the for-
mer, and ought equally to be promoted.
  When the pain is very  great, and the .patient reftlefe, thirtv or 
THE  GOUT.
*n
forty drops of laudanum, more or lefs, according to the violence of
the fymptoms,  may be taken at bed-time. This will eafe the pain,
procure reft, promote perSpiration, and forward the crifes of the
difeaSe.
   ASter the fit is over, the patient  ought to take a gentle doSe or
two of the bitter tincture  of rhubarb, or fome other warm fto-
machic purge. He fhould alfo drink a weak infufion of ftomachic
bitters in fmall wine or ale, as the bark with cinnamon, Virginian
fnake-root,  and orange-peel.  The diet at this time fliould  be
light,  but nourifhing, and  gentle exercife ought to be taken  on
horfeback, or in a carriage.
   Out of the  fit,  it is in the patient's power to do many things
towards preventing a return of the diforder, or rendering the
fit, if  it fhould return, lefs fevere.  This, however, is not to
be attempted  by medicine.   I have  frequently known the gout
kept off' for feveral years by the bark  and other aftringent medi-
cines ; but, in all the cafes, where I had occafion to fee this tried,
the perfons died fuddenly. and, to all appearance, for want of a re-
gular fit of the gout, which, to fome conftitutions, in the decline
of life, is rather falutary than hurtful.
   Though it may be dangerous to ftop a fit of the gout by me-
dicine, yet if the conftitution can be fo changed by diet and ex-
ercife, as to leffen or totally prevent its return, there certainly can
be no danger in following fuch a courfe.  The whole habit may
be altered by a proper regimen, as quite to eradicate this difeafe ;
and thofe only who have fufficient refolution to perfift in fuch a
courfe, have reafon to expect a  cure.
   The courSe which we would recommend Sor preventing the
gout, is as follows : In the firft place,  univerfal temperance.  In the
next place, fufficient exercife*. By this  we do not mean Sauntering
about in an indolent manner, but labour, Sweat, 2nd toil.  TheSe
only can render the humours wholeSome, and keep them So.  Go-
ing early to bed, and rifing betimes, are alSo oS great importance.
It is likewiSe proper to avoid night-ftudies, and all intenSe thought.
The Supper fhould be light,  and taken early.  All ftrong liquors,
eSpecially generous wines and Sour punch, are to be avoided.
   We would likewiSe recommend fome doSes oS magnefta alba and
rhubarb to  be taken every Spring and autumn ; and aSterwards  a
courfe of ftomachic bitters,  as tanfey or water-trefoil tea, an in-
fufion  of gentian and camomile flowers, or a decoction of burdock
root, &c. Any of thefe, or  an infufion of any wholefome  bitter
that is more agreeable to the patient, may be drank for two or
three weeks in "March and October twice a-day. An  iffue or per-
petual blifter has a great tendency to preveht the gout.  If thefe

  * Some  make a fecret of curing the gout by mufcular exercife  • This
fe;r.t, however, is as old  is Celfus, who ftrongly recommends thnt
mode of cure ;  a-d whoever will fubmit to it, in the fulleft extent, rmiy
e> ecf  to reap folid and permanent advantages.
                             M 2 
274
THE GOUT.
were  more generally uSed in the decline of life, they would not
only often prevent the gout, but alfo other chronic maladies. Such
as can afford to  go  to Bath, will find great benefit from  bathing
and  drinking the water.  It both promotes digeftion, and invigo-
rates the habit.
   Though there is little room for medicine during a  regular fit of
the gout, yet when  it leaves the extremities, and falls on fome of
the internal parts, proper applications to recal and fix it become
abfolutely neceffary. When the gout affects the head, the pain of
the joints ceaSes, and the Swelling disappears, while  either  Severe
head-ach, drowfineSs, trembling, giddineSs, convulfions, or  deli-
rium come on.  When it Seizes the lungs, great oppreffion, with
cough and  difficulty of" breathing, enSue. If it attacks the ftomach,
extreme fickneSs, vomiting, anxiety, pain in the epigaftric region,
and total lots of ftrength will fucceed.
   When the gout attacks'the  head or lungs, every method muft
be taken to fix it in  the feet. They muft be frequently bathed in
warm water,  and acrid cataplafms applied to the foles.  Blifters
ought likewife to be applied  to rhe ancles or calves oS the legs.
Bleeding in the  Seet or ancles  is  alSo neceffary, and warm ftoma-
chic purges. The patient ought to keep in  bed for the moft part,
if there be any figns of inflammation, and  fhould be very careful
not to catch cold.
   If it  attacks the ftomach with a fenfe of cold, the moft warm
cordials are neceffary ; as ftrong wine boiled up wich cinnamon
or other fpices ; cinnamon water; peppermint-water ; and even
brandy or rum.  The patient fhould keep his bed, and  endeavour
to promote a fweat  by drinking  warm  liquors ; and if he  fhould
be troubled with a  naufea, or  inclination to vomit, he may  drink
camomile tea, or any thing that will make  him vomit freely.
   When the gout attacks the kidneys, and imitates gravel-pains,
the patient ought to drink freely  of a deco£tion of marfh-mallows,
and to have the  parts fomented with warm water. An emollient
clyfter  ought likewiSe  to  be given, and aSterwards an opiate. If
the pain be very violent, twenty or thirty drops of laudanum may
be taken in a  cup of the decodtion.
   Perfons who have had the gout fhould be very attentive  to any
complaints that  may happen  to them about the time when they
have reafon to expect a return of the fit. The gout imitates many
other diforders,  and by being  mistaken for them, and treated im-
properly, is often diverted from its regular  courfe,  to the great
danger of life.
   Thofe who never had the gout, but who, from their conftitution
or manner of giving, have reafon to expect it, ought to be very
circumfpect with regard to its firft approach. If the difeaSe, by
wrong  conduct  or improper medicines, be diverted  from its pro-
per courfe, the patient has a chance  to be ever aSter tormented 
                 THE  RHEUMATISM.             275

with head-achs, coughs, pains of the ftomach and inteftines ; and
*o fall at laft a victim  to its attack upon fome of the more noble
parts.
                    Of the Rheumatifm.

  THIS difeafe has often a refemblance to the gout. It generally
attacks the joints with exquifite pain, and is fometimes attended
with inflammation and Swelling. It is moft common in the Spring,
and towards the  end of autumn. It is ufually diftinguifhed into
acute and chronic ; or the rheumatifm with and without a fever.
  CAUSES.----The caufes of a rheumatifm are frequently the
fame as thofe of an inflammatory fever, viz. an obstructed perfpi-
ration, the immoderate ufe  of ftrong liquors, and the  like. Sud-
den changes of the weather, and all quick tranfitions from heat to
cold, are very apt to occafion the rheumatiSm.   The' moft extraor-
dinary caSe oS a rheumatiSm that I  ever Saw,  where almoft every
joint of the body was diftorted, was a man who ufed to work one
part of the day by the fire, and the other part oS it in the water.
Very obftinate rheumatifms have likewiSe been brought on by per-
fons not accuftomed to it, allowing their feet to continue long wet.
The fame effects are produced by wet clothes, damp beds, fitting
or lying on the damp ground, travelling in the night, by exceffive
evacuations, or the ftoppage of cuftomary difcharges.  It is often
the effect of chronic difeafes, as the feurvy, the lues venerea, obfti-
nate autumnal agues, &c.
   The rheumatifm prevails in cold, damp,  marfhy countries. It
is moft common  among the poorer fort of peafants, who are ill
clothed,  live in low damp houfes, and eat coarfe unwholefome
food, which contains but little nourifhment,  and  is not eafily dU
 gefted.
   SYMPTOMS.----The  acute  rheumatifm commonly  begins
 with wearinefs,  fhivering, a quick  pulfe,  reftleffnefs, thirft, and
 other Symptoms of  Sever.  ASterwards the patient^ complains of
 flying pains, which increaSe by the leaft motion. Thefe at length
 fix in  the joints, which are often affected  with  Swelling and in-
 flammation.  If blood be let in this difeafe, it has generally the
 fame appearance as in the pleurify.
   In this kind of rheumatifm, the treatment of the patient is near-
 ly the fame as in an acute or inflammatory fever.  If he be young
 and ftrong, bleeding'is neceffary, which may be repeated accord-
 ing  to the exigencies of the cafe. The body ought to be kept open
 by emollient clyfters, or cool opening liquors ; as decoctions of
 tamarinds, cream of tartar whey, fenna tea, and the like.  The di-
 et fhould be light, and  in fmall quantity, confifting chiefly of 
576              THE RHEUMATISM.

r6afted apples, groat-gruel, or weak chicken broth. After the fe-
verifli fymptoms have abated, if the pain ftill continues, the patient
muft keep his bed, and take fuch things as promote perfpiration ;
as wine-whey, withfpiritus Mindereri, Sec  He may likewife take,
for a few nights,  at bed-time,  in a cup of wine-whey, a drachm
of the cream of tartar, and half  a diachm of  gum  guaiacum in
powder.
   Warm bathing, after proper evacuations, has oSten an exceed-
ing good  effect.  The patient  may  either be put into a  bath of
warm water, or have cloths wrung out of it applied to  the parts
affected. Great care muft be taken that he do not catch cold after
bathing.
   The chronic rheumatifm is feldom attended with any confider-
able degree  oS Sever, and is generally confined to Some particular
part oS  the body, as the  Shoulders, the back, or the  loins.  There
is Seldom any inflammation or Swelling in this caSe. PerSons in the
decline oS  liSe are moft  Subject to the chronic  rheumatiSm. In
fuch patients, it oSten proves extremely obftinate, and Sometimes
incurable.
   In this kind of rheumatifm the  regimen fliould be nearly tho»
fame as in the acute.  Cool  and diluting diet, as Stewed  prunes,
coddled apples, currants  or  goofeberries boiled in milk,  is moft
proper. Arbuchnot Says,  " IS there be a Specific in aliment Sor the
rheumatiSm, it is certainly whey ;" and adds, " that he  knew a
perSon Subject to this  difeaSe,  who  could never be cured  by any
Other  method  but a  diet oS whey  and bread.,:  He  Says, " that
cream of tartar in water-gruel,  taken for feveral days, will eaSe
rheumatic pains  considerably."  This  I have  oSten  experienced,
but Sound it always more efficacious when joined with gum guai-
acum, as already directed.  In this  caSe, the patient may take the
doSe formerly mentioned twice-a-day, and likewife a tea-fpoonful
of the  volatile tincture of gum  guaiacum, at bed time, in wine-
whey.
   This courfe may be continued for a week, or longer, if  the cafe
 proyes obftinate,  and the patient's ftrength will permit.  It ougnt
 then to be  omitted Sor a Sew days, and repeated again.   At the
 fame time leeches or a blifter may be applied  to  the part affected.
 What I haye generally Sound anSwer better than either oS thefe,
 in obftinate fi$ed rheumatic pains, is the warmplaifler *.   I have
 likewife known a plaifter of Burgundy pitch worn for fome time
 on the part  affected, give great relief in rheumatic pains. Dr. Alex-
 ander, of Edinburgh, fays he has frequently cured very obftinate
 rheumatic pains, by rubbing the part affected with tincture of can-
  tharides.  When the common tincture did not fucceed,  he ufed
  jt of a double cr treble  ftrength.  Cupping upen the part affected
# See appendix, Warm Plaifler. 
THE  RHEUMATISM.               277
is often very beneficial, and is greatly preferable to the application
of leeches.
  Though this difeaSe may not Seem to yield to medicines Sor Some
time, yet they ought ftill to be perfifted in.  PerSons Subject to fre-
quent returns oS rheumatiSm,  will oSten  find their account  in
ufing medicines, whether they  be immediately affected with the
difeafe or not. The chronic rheumatifm is fimilar to the  gout in
this refpect, that the  moft proper time for ufing medicines to ex-
tirpate it, is when the patient is moft free from the diforder.
   To thofe who can afford the  expenfe, I recommend the warm
baths of Buxton cr Matlock in Derbyfhire.  Thefe have often, to
my knowledge, cured very obftinate rheumatifms,  and are always
faSe either in or cut of the  fit. When the rheumatifm is compli-
 cated with fcorbutic complaints, which is not feldom the  cafe,
 the Harrowgate waters,' and thofe of  Moffat, are  proper.  They
 fhould both be drank and ufed as a warm bath.
    Several of our own domeftic plants may be ufed with advan-
 tage in the rheumatifm. One of the beft is white muflard. A table-
 fpoonful of the feed of this  plant may be taken twice or thrice
 a-day, in a glafs of water or fmall wine. The  watsr-trefoil is like-
 wife of great ufe in this complaint.  It may be inSuSed in wine or
 ale, or drank in Sorm of tea. The ground-ivy, camomile, and feve-
  ral other bitters are  beneficial, and may be ufed in the fame way.
 No benefit is to be expected from thefe, unlefs they be taken for
  a  confiderable time.  Excellent medicines are oSten deSpiSed in this
  difeafe, becaufe they do not perform an immediate cure; whereas,
  nothing woukl be more certain than their effect, were they duly
  perfifted in. Want of perfeverance in the ufe of medicines is one
  reafon why chronic  difeafes are fo feldom cured.
    Cold bathing, efpecially in fait water, often cures the rheuma-
  tifm. We alfo recommend riding on horfeback, and wearing flan-
.  nel next the fkin.   Iffues are very proper, efpecially in chronic
  cafes.  If the pain affects the  fhoulders, an iffue may be made in
  the arm ;  but if it affeas the loins,  it fhould be put in the leg
  or thigh.
    Perfons afflicted with the Scurvy are very  Subject to rheumatic
  complaints.  The beft  medicines in  this  caSe are bitters and mild
  purgatives.  TheSe may either be taken Separately or together, as
  the patient inclines. An ounce'oS bark, and half an ounce of rhu-
  barb in powder, may be infufed in a bottle of  wine ;  and one,
  two, or three wine glaffes oS it taken  daily, as fhall be Sound necef-
  fary'for keeping the body gently open.  In  cafes where the bark
  itfelf proves fufficiently purgative, the rheubarb may be  omitted.
     Such as are fubject to frequent attacks of the rheumatifm ought
  tomakechoife of  a  dry, warm Situation, to avoid the night-air,
  wet clothes, and wet feet, as much as poffible.   Their clothing
  fhould be warm ;  they fliould wear flannel next  their  fkin, and
  make frequent ufe of the flefh-brufh. 
2^8
               CHAPTER   XLI.

                        The Scurvy

    PREVAILS chiefly  in cold northern countries, efpecially in
     low, damp fituations, near large marfhes, or great quantities
of ftagnating water.  Sedentary people, of a dull, melancholy dif-
pofition,  are moft fubject to it.  It proves often fatal to failors on
long voyages, particularly in  Ships that are not properly ventila-
ted, have many people on board,  or  where cleanlineSs is neglec-
ted.
   It is not neceffary to mention the  different fpecies into which
this difeafe has been divided, as they differ from one another chief-
ly in degree.  What is called  the land feurvy,  however, is feldom
attended with thofe"highly putrid fymptoms which appear in pa-
tients who have been long  at  fea, and which, we prefume, are
rather owing to confined air.  want of exercife, Scarcity of water,
and the unwholefome food eaten by failors on long voyages, than
to any fpecific difference in the difeafe.
   CAUSES.----The feurvy is occafioned by cold, moift air; by
the long  ufe of falted or fmoke-dried provisions, or any kind of
food that is  hard of digeftion,  and affords little norifhment. It may
alfo proceed from theTuppreffion of cuftomary evacuations ; as the
menfesy the  hemorrhoidal fhix, &c.   It is  fometimes owing to  a
hereditary taint, in which cafe, a very fmall caufe will excite the
latent diforder. Grief, fear, and other depreffing paffions, have  a
great tendency both to excite  and aggravate this difeafe. The fame
obfervation  holds with regard to neglect of cleanlinefs;  badcloth-
ing ; the want of  proper exercife ; confined air; unwholefome
 food ; or any difeafe which greatly weakens the body.
   SYMPTOMS.----This difeafe maybe known by unufual wea-
rinefs, heavinefs, and difficulty of breathing, efpecially  after mo-
tion ; rottennefs of the gums, which  are apt to bleed on the flight-
eft touch;  a  ftinking breath ; frequent  bleeding at the  nofe;
 crackling of the joints ; difficulty of walking ; fometimes a fwel-
 ling, and fometimes a falling away of the legs, on which'there are
 livid, yellow, or  violet-coloured fpots ; the face is generally of a
 pale or leaden colour.   As the difeafe advances,  other fymptoms
 come on ; as rottennefs of the teeth, hemorrhages, or difchar-
 ges of blood from different parts of the body, foul obftinate ulcers,
 pains in various parts, efpecially about the breaft, dry, fealy erup-
 tions all over the body,  &c.   At laft, a wafting or hectic fever
 comes on, and the patient is often carried off by a dyfentery, a
 diarrhoea, a dropfy, the palfy, fainting fits, or a  mortification of
 fome of the bowels.
    CURE.----We  know no way  of  curing this difeafe but by 
THE  SCURVY.
279
purSuing a plan directly oppofite to that which brings it on. It is
occafioned by errors in diet, air, or exerciSe ;  and this cannot be
removed but by a proper attention to theSe important articles.
  IS the patient has been obliged.to breathe a cold, damp, or con-
fined air, he fhould be removed, as Soon as poffible, to a dry, open,
and moderately warm one.  IS there is reaSon to believe that the
diSeaSe proceeds Srom a Sedentary  liSe, or depreffing  paffions, as
grieS, fear, &c. he muft take, daily,  as much exercife in the open
air as he can bear, and his mind  Should be diverted by  cheerSul
company and other amuSements.  Nothing has a greater tendency
either to prevent  or remove this diSeaSe,  than conftant cheerful-
nefs and good humour. But perfons afflicted with the feurvy, are
generally furly, pcevifh, and morofe.
   When the feurvy comes on by  a long ufe of falted provifions,
the proper medicine is a diet confifting chiefly of frefh vegetables;
as oranges, apples, lemons, limes,  tamarinds, water-crifles, feurvy-
grafs,  brook-lime, Sec.   The ufe  of thefe,  with milk, pot-herbs,
new-bread, and frefh beer or cyder, will feldom fail to remove a
feurvy of this kind, if taken before it be too far advanced ; but to
have this effect they muft be perfifted in for a confiderable time.
When frefh vegetables  cannot be obtained, pickled or preServed
ones may be ufed; and wfiere theSe are wanting, recourSe muft
 be had to the chemical acids.  All the, patient's Sood and drink,
 fhould, in  this cafe, be fliarpened with cream,of tartar, elixir of
 vitriol, vinegar, or the fpirit of fea-falt.
   Thefe things, however, will more certainly prevent than cure
 the feurvy ; Sor which reaSon, Sea-faring people, efpecially on long
 voyages, ought to lay in plenty of them.  Cabbages, onions,goofe-
 berries, and many  other vegetables, may be  kept a.long time by
 pickling, preferving, Sec. and when theSe Sail, the chemical acids,
 recommended above, which will keep Sor any length oS time, may
 be uSed. We have reaSon to believe, iS Ships were well ventilated,
 had good Store of fruits, greens, cyder, &c. laid in, and  if proper
 regard were paid to cleanlinefs and warmth, that failors would be
 the  moft healthy people in  the  world, and  would feldom fuffer
 either from the feurvy or malignant fevers, which are fo,fatal to
 that ufeful fet of men ; but it is too much their temper to defpife
 all precaution; they will not think of any calamity till it overtakes
 them, when it is too late to ward  off the blow.
   It muft indeed be owned,  that  many of them have it not in
 their power to make the provifioh we are Speaking oS; but in this
 caSe it is the duty oS their employers to make  it Sor them ;  and no
 man ought to engage in a long voyage without having theSe articles
 Secured.
   I have often feen very extraordinary effects in the Jand-feurvy
 from a milk diet.  This preparation of  nature, a mixture of ani-
 mal and vegetable properties, is the moft fit for restoring a decay-
ed conftitution. But people defpife this wholefome and nourifliing 
28o    *            THE SCURVY.
Sood, bccauSe it.is cheap, and devour with  greedinefs, flefh, and
fermented liquors, while milk is only deemed fit for hogs.
  The moft proper chink in the feurvy i? whey or  butter-milk.
When thefe cannot be had, found cyder, perry, porter or Spruce-
beer, may be uSed.  Wort has been Sound a proper drink in the
feurvy, and may be ufed at Sea, as malt will keep during the longeft
voyage.  A decoction oSthe tops oS the  Spruce fir is likewiSe pro-
per. It may be drank  in the quantity oS an Englifh pint  twice a-
day. Tar-water may be uSed Sor the Same purpoSe, or decoctions
of any oSthe mild mucilaginous vegetables ; as farfaparilh, marfh-
mallowroots, &c.   Infufions  of the bitter plants, as ground-ivy,
the leffer centaury, marfh-trefoil, &c. are beneficial. The peafants
in fome parts of Britain, exprefs the juice of the laft-mentioned
plant, and drink it with good effect in thofe foul, fcorbutic erup-
tions with which they are often troubled in the fpring feafon.
   Harrowgate-water  is  certainly an excellent medicine  in the
land-fcurvy.   I have often feen patients who had been reduced to
the moft deplorable condition by this difeafe,  greatly relieved by
drinking the fulphur-water, and bathing in it.   The chalybeate-
water may alfo be ufed  with  advantage, eSpecially w ith a view to
brace the ftomach aSter drinking the Sulphur-water, which, though
it fharpens the appetite, never  Sails  to weaken  the  powers of
digeftion.
   A flight degree oS Scurvy may be carried off by Srequently Suck-
ing a little oS the juice oSa bitt  r or?.nge, or a lemon.  When the
diSeaSe  affects the gums only, this practice, iS continued Sor Some
time, will generally carry it off.  We recommend the bitter orange
as greatly preSerable to lemon •, it Seems to be as good a medicine,
and is not near So hurcSul to the ftomach. Perhaps our own Sorrel
may be little inferior to either of them.
   AH kinds oS Sallad are good in the Scurvy, and ought to he eaten
very plentifully, as fpinage,  lettuce, parfley, celery, endive, rad-
ifh, dandelion, &c.  It is amazing to fee how foon  frefh vegeta-
bles in the fpring cure the brute animals of any feab or foulnefs
which is upon  their fkins. It is reafonable  to  fuppofe that their
effects would be as grea,t upon the  human fpecies, were they ufed
in proper quantity for a  fufficient length of time.
   I have fometimes feen good effects in fcorbutic complaints of
very long ftanding,  from the ufe of a decoction of the roots of wa-
ter-dock.  It is ufually made by boiling a pound of the frefh root
in fix Englifh'pints oS water, till about  one-third of it be con fum-
ed. The dofe is from  half a pint to a whole pint of the docoction
every day.  But in all the cafes where 1  have feen it  prove  benefi-
cial, it was made much ftronger, and drank in  larger  quantities.
TheSafeft way is, for the patient to begin  with fmall dofes, and
increafe  them  both in ftrength and quantity as he finds his fto-
mhch will bear it.  It muft be ufed for a confiderable time.  I have
known feme take it far many months, and have been told of orh.-.s 
       TEE  SCROPHULA, Ok KING'S EVIL.    2^

who had ufed it for feveral years, before they were fenfible ot any
benefit, but who nevertheless were cured by it at length.
   'i he  leproSy, which was So common in this country long ago,
feems to have been near a-kin  to the feurvy. Perhaps its appear-
ing fo  Seldom  now, may be owing to tht inhabitants of Britain eat-
ing more vegetable food than formerly, living more upon tea, and
Other diluting diet, ufing lefs falted meat, bein^ more cleanlv, bet-
ter lodged and clothed, &c.—For the cure of this difeafe, we re*
commend the  fame courfe of diet and medicine as in the feurvy.
              The Scrophula, or King9s Evil

  CHIEFLY affects the glands, efpecially thofe of the neck. Chil-
dren, and yourig  perfons  of a fedentary  life, are  very fubj.£t
to it.  It is one of thofe difeafes which may be removed  by proper
regimen, but feldom yields to medicine. The inhabitants of cold,
damp, marfhy countries are moft liable to the ferophula.
  CAUSES.----i his  difeafe may proceed from a hereditary
taint, from a fcrophulous nurfe, Sec. Children who have the mis-
fortune to be born of fickly parents,  whofe conftitutions have been
greatly injured by the pox, or other chronic difeafes* are apt to be
affected with it.  It may proceed from fuch difeafes as weaken the
habit, as the fmall-pox,  meafls, &c. External injuries, as blows,
bruifes, and the like, fometimes produce fcrophulous ulcers;  but
we believe, when this  happens, that  there has  been a predifpofi-
tion in the habit to this  diSeaSe. In  Short, whatever tends to relax
the Solids, paves the way to the Scrophula ; as the want of proper
fexerciSe, too much heat or cold, confined air, unwholeSome  food,
bad water, the long ufe of poor, weak, watery aliments, the  ne-
glect of cleanlinefs, &c.  Nothing  tends more  to induce this dif-
eafe in children, than allowing them to continue long wet*.
   SYMPTOMS____At firft, fmall knots appear under the  chin
 or behind the  ears, which gradually increafe in number and  fize,
 till they form one large hard tumour. This often  continues  for a
 long time without breaking, and when it does break, it only dif-
 charges a ihmfmies, or watery humour. Other parts of the  body
 are  likewife  liable to its attack,  as the arm-pits,,  groins,  feet,
 hands, eyes, brcafts,'&c  Nor are  the internal  parts exemptfrom
 It.  It often affects the  lungs, liver, or fpleen ;  and frequently the
 glands  of the myfeutery are greatly enlarged by it.
   ThoSe obftinate ulcers which, break out upon the feet and hands
 with fwelling, and little or no rednefs, are of the fcrophulous kind.
 They feldom  difeharge good matter,  and are exceedingly difficult

   *■ The ferophula, as well as the rickets, prevails in  l°.rge manufap
 Hiring towns j where peopielive grofs,  and leid f^fentary lives.
                               N  2 
282   THE SCROPHULA,  OR KING's EVIL.

to cure. The white fwelling of the joints feems to be of this kiRd,
They are with difficulty brought to a Suppuration, and when open-
ed,  they only diScharge a thin ichor.  There is not a more general
fymptom of the ferophula than a Swelling of the upper Hp and
nofe.
  REGIMEN.----As this difeafe proceeds, in a great  meafure,
from relaxation, the diet ought to be generous and nourifliing, but
at the fame time, light and oS eaSy digeftion ; as well fermented
bread, made of found grain, the flefh and broth of young animals,
with a glafs of generous wine, or good ale.  The air ought  to be
open, dry, and not too cold, and the patient fhould take as  much
exercife as he can bear.  This is of theutmoft importance.   Chil-
dren who have fufficient  exercife are feldom troubled with the
ferophula.
   MEDICINE.----The  vulgar are remarkably credulous with
regard to the cure of the ferophula ;  many of them  believing in
the virtue of the royal touch, that of the feventh fon, &c.  We
know but little of the nature  or cure of this difeafe,  and where
reafon or medicines fail, fuperftition  always  comes in their  place.
Hence, in difeafes which are the moft difficult to underftand, we
generally  hear of the  greateft number of miraculous cures being
performed.  Here, however, the deception is  eafily accounted for.
The ferophula, at  a certain period of life, often cures of  itfelf;
and, if the patient happens to be touched about this time, the
cure is imputed to the touch, and not to Nature. In the fame way,
the  infignificant noftrums of quacks and old women often gain ap-
plaufe when they deferve none.
   Nothing is more pernicious than the cuftom of plying children
in the ferophula with ftrong purgative medicines. People imagine
it proceeds from humours  which rnuft be purged off, without con-
fidering that thefe purgatives increaSe the debility and  aggravate
the diSeaSe. It has indeed been found, that keeping the body gen-
tly open for fome time, efpecially with fea-water, has a good ef-
fect ; but this fhould only be given in grofs  habits, and in fuch
quantity, as to procure one, or at moft, two ftools every day.
   Bathing in the fait water has likewife a very good effect; eSpe-
cially in the warm Seafon.  I have often known a courSe oS bathing
in Salt water, and drinking it in Such quantities as to keep the bo-
dy gently open* cure a ferophula,  after many other  medicines had
been tried in vain.  When fait water  cannot  be obtained, the pa<-
tient may be bathed in  frcfii water,  and his body kept open by
fmall quantities of fait and water, or fome  other mild purgative.
   Next to cold bathing, and drinking the fait water, we recom-
mend the bark.  The  cold -bath may be ufed in fummer, and the
 bark in winter. To an adult, half a drachm of the bark in  powder
 may be given in a glafs of red wine four or five times a-day. Chil-
dren, and fuch as cannot take it in fubftance, may ufe the  decoc-
tion made in. the following manner. . 
THE ITCH.                   2S3
  Boil an ounce of Peruvian bark'and a drachm of Winter's bark,
both grofsly powdered, in an E-nglifh  quart  of water to a  pint:
towards the end, half ar. ounce of fliced liquorice-root, and a hand-
ful of raifins may be added, which will both render the decoction
leSs diSagreeable,  and make it take up more oS the bark.  The li-
quor muft be ftrained, and two, three, or Sour table-fpoonfuls, ac-
cording to the age of the patfent, given three times a-day.
  The  Moffat and Harrowgate waters,  efpecially the latter, are
likewife very proper medicines in the ferophula. They ought not
to be drank in large quantities, but  fo as to keep the body gently
open, and muft be ufed for a confiderable time.
  Hemlock may Sometimes be ufed with advantage in the ferophu-
la. Some lay it down as a general rule, that the Sea-water is  moft
proper before there are any fuppuration or fymptoms of tabes', the
Peruvian bark, when there are running fores,  and a degree of hec-
tic fever ; and  the hemlock  in old inveterate cafes, approaching
to the fehirrous or cancerous ftate. Either the extract or the frefh
juice of this plant may be ufed.  The dofe mult be fmall at  firft,
and increafed gradually as far as the  ftomach  can bear  it.
  External applications are of little ufe. Before the tumour breaks,
nothing ought to be applied to it,  unlefs.a piece of flannel or fome-
thing to keep it warm.  After it breaks, the  fore  may be dreffed
with fome digeftive ointment. As the yellow bafilicon mixed  with
about a fixth  or eighth part of its weight of red precipitate of mer-
cury.  The fore may be dreffed with this twice a-day ;  and if it be
very  fungous, and  does notdigeft well, a larger proportion of the
precipitate may be added.
  Medicines which mitigate this difeafe,  though they do not cure
it, are not to be defpifed. If the patient can be kept alive by any
means till he arrives at the age of puberty, he has a great chance
to get well;  but if he does not recover at this time, in all probabi-
lity, he never will.
  There is no malady which parents  are fo apt  to communicate
to their offspring as the ferophula, for which reafon, people ought
to beware of marrying into families affected with this difeafe.
  For the  means of preventing the ferophula, we muft refer the
reader to  the obfervations on nurfing at the beginning  of the
book.
                          The Itch

  IS commonly communicated by infection, yet it feldom pre-
vails  where due  regard  is paid to  cleanlinefs,  frefh air, and
Wholefome diet. It generally appears in form of fmall watery puf-
tules, firft about the wrifts, or between the fingers; afterwards 
i»4                   THE ITCH.
it affe£rs the arms, legs, thighs, &c.  Thefe puftules nre attended
with an intolerable itching, efpecially when the patient is warm a-
bed, or fits by  the fire. Sometimes, indeed, the fkin is covered with
large blotches or feabs, and at otfer times wuh a white Scurf,  or
fcaly eruption.  This laft is called the dry itch, and is the moft dif-
ficult to cure.
   the itch is feldom a dangerous difeafe, unlefs when rendered
fo by neglect,  or improper treatment. IS fuflered to continue too
long,  it  may vitiate the whole mafs of blood, and, if Suddenly
diuve  in, without proper evacuations, it may occafion fevers, in-
flammations oS the viScera, or other internal diSorders.
   The beft  medicine Sor the itch is  Sulphur, uSed both externally
and internally. The parts moft affected may be rubbed with  an
ointment made of the ffewers of fulphur,  two ounces ;  crude  Sal
ammoniac  fintly powdered, two drachms; hog's lard,  or  butter,
four ounces. If a Scruple or h ilf a drachm  of the effence of lemon
be added,   it  will  entirely take away the difagreeable  fmell.
About the bulk of a nutmeg oS this may be rubbed upon the ex-
tremities at bed time twice or thrice a-week.  It is feldom necef-
fary  to rub the whole body ; but when it is, it ought not to be
dune all at once, but by turns, as it is dangerous to ftop too ma-
ny pnres at the fame time-
   Before  the p-.tient begins to  uSe the ointment, he ought, if he
be of a full habit, to bleed or take a purge or two. It will likewife
be proper,  during the uSe  of it, to take every  night and morning
as much of the flour of bnmftone and cream of tartar, in a little
tre.de or new milk, as wiii keep the body gently open.  He fliould
beware of catching  cold, fhould wear more clothe3 than ufuai, and
take  every thing warm.   The fame clothes, the linen excepted,
ought  to be worn ail the  time  of ufing the ointment;  and Such
pluthes as haye been w< rn while the patient was under the diSeaSe,
are not to be  uSed  again,  unleSs  they have been fumigated with
brimftone, and thoroughly cleaned ; otherwise, they will commu-
nicate the  infection anew  .
   I never  kucw brimftone, when uSed as directed above, fail to
cure the itch ;  and  I believe that iS duly perfined in, it never will
fail ;  but if it be only ufed once or  twice, and cleanlineSs neglec-
ted,  it is no wonder if the diforder returns. The quantity  of oiiiU
ment, mentioned above, will generally be fufficient for the cure c£
one  perfon  ; but if any fymptoms of the  difeafe fhould appear a-
gain, the medicine  may be repeated. It is  both more fafe and tfli-

   * Sir John Pringle obferve-, that though this difeafe rmy feem trifling,
there is no «ne in the army that is more troublefome to cure, as the iii-
fc-csion often lurks  in clothes, &c. and breaks out a fecor.d cr even a
third time   The fame inconvenien. \ occurs in private families, uniefs
p-r :cw'.-«.r rcvaard is paid to  the ^han^im; or  cleaning  of their cioiavs,
which . i!t is by no means an eafy opt eft .10:1. 
THE  ITCH.                     285
cacious when  perfifted  in for a  confiderable  time, than when a
Urge quantity is applied at once.  As moft people diflike the fmell
of fulphur, they may ufe in ks place the powder of white hellebore
root made up into an ointment, in the fame manner,  which will
feldom fail to cure the itch.
  People ought to be extremely cautious left they take other erup-
tions for the itch ; as the ftoppage of thefe may be attended with
fatal confequences. Many of the eruptive diforders to which chil-
dren are liable, have a near refemblance to  this difeafe;  and I
have often known infants killed by being rubbed with greafy oint-
ments that made thefe eruptions Strike Suddenly in, which Nature
had thrown out to preferve the patient's life, or prevent fome other
malady.
   Much miSchieS is likewiSe  done by the  ufe of mercury in this
diSeaSe. Some perfons wafh  the parts affected with a ftrong Solu-
tion of the corrofive fublimate. Others ufe the mercurial ointment.
without  taking the leaft care either to avoid  cold, keep the body
open, or obferve a proper regimen. The confequences may be ea-
fily gueffed.   Mercurial girdles have produced bad effects, and I
would advice every perSon, as he values his health, to beware how
he uSes them.   Mercury  ought never to be  ufed as a medicine
without the greateft care.   Ignorant people look upon thefe gir-
dles as a kind of charm, without confidering that the mercury en^
Jers the body.
   It is not to be told  what  miSchief is done by ufing mercurial
ointment for curing, the itch and killing vermin ;  yet it is  unne-
ceffary for either : the former may be always more certainly cured
by  fulphur, and the latter will never be found where due regard
is paid to cleanlinefs.
  ^ Thofe who wifh to avoid this deteftable diSeaSe, ought to beware
of infected perfons, to ufe wholefome food, and to ftudy univerfal
cleanlinefs*.
  * The itch is now by cleanlinefs banifhed from every genteel family
in Britain.  Ic ftill prevails among the poorer fort of peafants in Scot-
land, and among the innnufa&urers in England.  Thefe are not only fuf-
ficient to keep the feeds of the difeafe alive, but to fpread the infa-tliort
among others.  It were to be wiihed,that fome effectual method could
be devifed  for extirpating it altogether.  Several country clergymen
have told me, that by getting fuch as were infected cured, and ftrongly
recommending an attention to cleanlinefs, they have baniihed  the itca
entirely out of their pariihes. Why might not others do the fame ? 
286
                CHAPTER   XLII.


                        The  Afthma

   IS a diSeaSe oSthe lungs, which Seldom admits of a cure. Per-
    fons in the decline of life are mcft liable to it. It is diftinguifh-
 ed into the moift and dry, or  humoural and nervous. The for-
 mer is attended with expectoration or fpitting ; but in the latter,
 the patient feldom fpits, unlefs fometimes a little tough phlegm
 by the mere force of coughing.
   CAUSES.----The  afthma  is  fometimes hereditary.   It may
 likewife proceed from a bad  formation of the  breaft; the fumes
 of metals or minerals taken into the lungs ; violent exercife, ef-
 pecially running ; the  obstruction  of cuftomary evacuations, as
 the menfes, haemorrhoids, &c. the fudden retroceflion of the gout,
 or ftriking in  of eruptions,  as the fmall-pox, meafles,  &c. vi-
 olent paflions oS the mind, as Sudden Sear or SurpriSe.  In a word,
 the difeaSe may  proceed Srom  any caufe that either impedes  the
 circulation of the blood through the lungs, or prevents their being
 duly expanded by the air.
   SYMPTOMS_____An afthma is known by a quick laborious
 breathing, which is generally performed with a  kind of wheezing
 noife. Sometimes the difficulty of  breathing is  fo great, that  the
 patient is obliged to keep in an erect pofturetipth,erwife he is in
 danger oS being Suffocated.  A fit  or paroxyfim of the afthma  ge-
 nerally happens after a perfon has been expofed to cold eafterly
 winds, or has been abroad in thick  Soggy weather, or has got wet,
 or continued long in  a damp place under ground,  or  has taken
 fome Sood which the ftomach could not digeft,  as paftries, toaft-
 ed cheeSe, or the like.
    The paroxySm is commonly ufhered in with liftleflhefs, want
 ef fleep, hoarfeneSs, a cough, belching of wind, a SenSe of heavi-
 nefs about the breaft,   and  difficulty of breathing.  To thefe fuc-
 ceed heat, Sever, pain of the head,  ficknefs and  nauSea, great op-
 preffion oS the breaft, palpitation oS the heart, a weak and Some-
 times intermitting pulfe, an involuntary flow oS tears, bilious vo-
 mitings, &c.  All the Symptoms grow worSe towards night; the
 patient is eafier when up than in bed, and is very defirous oS cool
 air.
   REGIMF.N-----The food ought to be light and of eafy digef-
 tion. Boiled meats are  to be preferred to roafted, and the flefh of
 young  animals to that of old. All windy food, and whatever is apt
 to fwell in the ftomach, is to  be avoided. Light puddings, white
 broths,  and ripe  fruits, baked,  boiled, or roafted, are  proper.
Strong liquors, of all kinds, efpecially malt liquor, are  hurtful.
The patient flioedd eat  a very li^lit  fupper, or rather none  at all, 
                     THE ASTHMA.                207

and fhould never fuffer himfelf to be long coftive. His clothing
fliould be warm, efpecially in the winter-feafon.  As all diforders
of the breaft are much relieved  by keeping the feet warm,  and
promoting  the perfpiration, a flannel fliirt or waiftcoat, and thick
jfiioes, will  be of Singular Service.
   But nothing is oS So great importance in the afthma as pure and
moderately warm air.  Afthmatic people can  Seldom bear either
the cloSe heavy air  oS a large town, or the fharp, keen atmof-
phere of a bleak hilly country ; a medium therefore between thefe
is to be chofen. The air near a large town is often better than at
a diftance,  provided the patient be removed fo Sar as not to be af-
fected by the Smoke.  Some afthmatic patients breathe  eafier  in
town than  in the country; but this is feldom  the caSe, eSpecially
in towns where much coal is burnt. Afthmatic perfons who are
obliged to  be in town all day, ought at leaft  to  fleep  out of  it.
This w ill often prove of great fervice.  Thofe who can afford  it,
ought to travel into a warmer climate. Many afthmatic perSons,
who cannot live in Britain, enjoy very good health in the South of
France,  Portugal,  Spain,  or Italy.
   ExerciSe is oS very great importance in the afthma, as it promotes
the digeftion, preparation of the blood, &c. The blood of afthma-
tic perfons is  feldom duly prepared, owing to the proper action
of the lungs being impeded.   For this reafon, fuch people ought
daily to take as much exercife, either on foot, horfeback,  or in a
carriage, as they can bear.
   MEDICINE..----Almoft all that can be done by medicine in
 this difeafe, is to relieve the patient when feized with a  violent
fit. This, indeed,requires the greateft expedition, as the difeafe of-
ten proves fuddenly fatal. In the paroxyfm or fit, the body is ge-
 nerally bound ; a purging clyfter, with a Solution of afafoctida,
ought therefore to be adminiftered, and if there be occafion, it may
 be repeated two or three times.  The patient's  feet and  legs ought
 to be immerfed in warm water, and afterwards rubbed with a
warm hand, or dry cloth.  Bleeding, unlefs extreme weaknefs or
 old age fhould  forbid it,  is highly  proper.  If there be a violent
 fpafm about the breaft or ftomach, warm fomentations, or blad-
 ders filled  with warm milk and water, may be applied to the part
 affected, and warm cataplafms to the Soles oS the Seet.   The pa-
 tient muft drink Sreely oS diluting liquors, and may  take a tea-
 SpoonSul of the tincture of caftor  and of faffron mixed together,
 in a cup of valerian-tea, twice or thrice a-day.  Sometimes a  vo-
 mit has a  very good effect, and fnatches the patient from the jaws
 of death. This, however, will be more fafe after other evacuations
 have been  premifed.   A very ftrong infufion of roafted coffee is
 faid to give eafe in an afthmatic  paroxyfm.
   In the moift afthma, fuch things as promote expectoration or
 fpitting ought to be ufed ; as the fyrup of fquills, gum ammoniac,
 and fuch-like.  A common fpoonful of the  fyrup,  or  oxymel of 
288                TiJE APOPLEXY.

fquills, mixed with an equal quantity of cinnamon-water, may be
taken three or four times through the day, and four or five pills,
made of equal parts of afafoetida and gum-ammoniac, at bed time*.
  For the convulfive or nervous afthma, antifpafmodics and bra-
cers are the moft proper  medicines. The patient may take a tea-
fpoonful of the paregoric elixir twice a-day. The bark is Sometimes
of ufe in this cafe.   It may be taken in  fubftance, or infufed in
winef.  In fhort, every thing that braces the nerves, or takes off
fpafm, may be of ufe in a nervous afthma. It is often relieved by
the ufe of afles' milk. I have likewife known  cow's milk, drank
warm in the morning, have a very good  effect in thi9 cafe.
  In every fpecies of afthma, fetons and iffues have a good effect.
They may either be fet in the back or fide, and fhould never be al-
lowed to dry up.  Not  only  in the afthma, but in moft chronic
difeafes, iffues are extremely proper.   They are a SaSe and effica-
cious remedy; and though they do not always cure thediSeaSe, yet
they will often prolong the patient's life.
               CHAPTER   XLIII.


                       Of the Apoplexy.

      THE apoplexy is a fudden lofs of fenfe and motion, wherein
      the patient is  to all appearance dead.  The heart and lungs
 however ftill continue to move. This difeafe proves oSten fatal; yet
 it may fometimes be  removed by proper care.  It chiefly attacks Se-
 dentary perSons, oS a groSs habit, who uSe a rich and plentiSul diet,
 and indulge in ftrong liquors.  People  in the decline  of life are
 moft fubject to the apoplexy.  It prevails moft in winter, eSpecial-
 ly in rainy SeaSons, and very low ftates of the barometer.
   CAUSES-----The immediate caufe  of  an apoplexy is a com-
 preffioj) oS the brain, occafioned by an exceSs of blood, or a collec-
 tion of watery humours.  The former is called a Sanguine, and the
 latter, a ferous apoplexy.  It may be occafioned  by any thing that
 increafes the circulation towards the brain, or prevents the return

   ■3f After copious evacuations, large dofes  of aether have been found
 very efficacious in removing a fit of the aithma  I have likewife known
 fehe following mixture produce very  happy effects :  To  four or five
 ounces of the folution of  gum-ammoniac, add two  ounces of limple
 cinnamon-water, the fam-qu mtity of balfamic fyrup, and half an ounce
 of the paregoric elixir. Of this, u\ o table-fpooniuis may be taken eve-
 ry three hours.

  t When a paroxyfm  or fit of afthma has gone off, cold bathing may be
employed, to co-operate wkh the ionic medicines reconiniended, to
prevent a return of the paroxyfm.            (I, q\ 
                   THE APOPLEXY.                289

 of the blood from the head; as intenfe ftudy;  violent paffions* ;
 viewing objects for a long rime obliquely ;  wearing any thing too
 tight about the neck ;  a rich and luxurious  diet; Suppreffion of
 urine ; fuffering the body to cool fuddenly aSter having been great-
 ly heated; continuing long in a warm or a cold bath; the excef-
 five uSe oSSpiceries, or high-SeaSoned food ; exceSs of venery ; the
 fudden ftriking in of any eruption ; Suffering iffues,  Setons, &c.
 fuddenly to dry up, or the ftoppage oS ahy cuftomary evacuation ;
 a mercurial Salivation pufhed too Sar, or Suddenly checked by cold ;
 wounds or bruiSes on the head; long expoSure  to exceffive cold ;
 poiSonous exhalations, &c.
   SYMPTOMS, and method of cure.-----The ufual forerunners
 of an  apoplexy are giddinefs, pain and fwimming of the head;
 lofs of memory ; drowfinefs ; noife in the ears ;  the night-mare ;
 a fpontaneous flux of tears, and laborious refpiration.  When per-
 fons of an apoplectic make obferve thefe fymptoms, they have rea-
 fon to fear the approach of a fit, and fhould endeavour to prevent
 it by bleeding, a flender diet,  and opening medicines.
   In the  Sanguine apoplexy, if the patient does not die fuddenly,
 the  countenance appears florid, the face is  fwelled or puffed up,
 and the blood-veffefs, efpecially about  the neck and. temples, are
 turgid ; the pulfe beats ftrong; the eyes are prominent and fixed,
 and the breathing is difficult, and performed with a  Snorting noife.
 The excrements and urine are oSten voided Spontaneously, and the
 patient is Sometimes  Seized with vomiting.
   In this Species oS apoplexy, every method muft be  taken to leffen
 the force oS the circulation towards the head.  The  patient fhould
 be kept perfectly eaSy and cool.  His head fhould be raiSed pretty
 high, and his Seet Suffered to hang down.  His clothes ought  to
 be looSened, eSpecially afeout the neck, and Srefh air admitted into
 his chamber.   His garters fhould be tied pretty tight, by which
 means the motion of the blood from the lower extremities will be
 retarded.  As foon as he is placed in a proper poture, he fhould be
 bled freely in the neck or arm, and, iS there be occafion, the  ope-
 ration may be repeated in two or three hours.   A laxative clyfter,
 with plenty oS Sweet oil, or Srefh butter, and a Spoonful or two of
 common Salt in it may be adminiftered  every  two  hoursf, and a

   * I knew a woman, who, in a violent fit of anger, was feized with a
 fanguine apoplexy. She at firft complained of extreme  pain, as if dag-
 ger had been thruft through herhe^d. as Ihe expreffedit.   Afterwards
 Ihe became comatofe, her pulfe funk very low, and was exceeding flow.
 By bleeding, biiltering, and other evacuations, fhe was kept alive about
 a fortnight. W hen her head was opened, a large quantity of extravafa-
 ted blood  was found in the left venteicle ot  the brain.

  t \ clyfter, confifting of three ounces of glauber falts diffolved in a pint
of warm water, with an ounce of antimonial wine, and a fuitable quan*
lity of ail, would have a more powerful effect in relieving the head.
                                                   (I. C.)
                                 o  % 
290
THE APOPLEXY.
 blifter  appplfed between the moulders, and to the calves of trie
 legs.
   As foon as the fymptoms are a little abated, and  the patient is
 able to Swallow, he ought to drink Sreely oS Some diluting opening
 liquor, as a deco&ion of tamarinds and  liquorice, cream-tartar
 whey,  or common whey with cream of tartar diffolved in it. Or
 he may take any cooling purge, as Glauber's falts, manna diffolved
 in an infufion of fenna, or the like.  All fpirits and other ftrong
 liquors are to be avoided.  Even volatile falts held to the nofe do
 mifchief. Vomits, fer the fame reafon, ought not to be given, nor
 any thing that may increafe the motion of the blood towards the
 head.
   In the ferotrs apoplexy, the fymptoms are nearly the fame, only
 the pulfe is not fo ftrong, the countenance  is lefs florid,  and the
 breathing lefs difficult. Bleeding is not fo necefiary here as'in the
 former cafe. It may generally be performed once with fafety and
 advantage,  but fhould not be repeated. The patient  fhould be
 placed  in the  fame pofture as directd above,  and fhould have blif-
 ters  applied,  and receive  opening clyfters  in the fame manner.
 Purges are likewife neceffary, and the patient may drink ftrong
 balm-tea. IS he be inclined to Sweat, it ought to be promoted by
 drinking Small wine-whey, or an'infufion  of carduus benedictus.
 A plentiful fweat kspt up for a confiderable time has often carried
 off a Serous apoplexy.
   When apoplectic fymptoms proceed from opium, or other nar-
 cotic fubftances taken into the  ftomach, vomits  are neceffary.
 The patient is generally  relieved a& idbn as he has difcharged the
 poifon  in this way.
   Perfons of an apoplectic make, or thofe who have been attack-
"ed by an apoplexy, ought  to ufe  a very fpare and  flender diet,
 avoiding all  Strong  liquors, fpiceries, and  high feafoned  food.
 They ought likewife to  guard againft  all violent paffions, and to
 avoin the extremes of heat and cold. The head fhould be fhaved*
 and daily wafhed  with cold water.  The  feet ought to be  kept
 warm, and never fuffered to continue long wet.  The body muft
 be kept open either  by food or medicine,  and a little blood may
 be let every fpring and fall. Exercife fhould by no means be ne-
 glected ; but it ought to be taken in moderation. Nothing has a
 more happy effect in preventing an apoplexy than perpetual iffues
 or fetons ; great care however muft be taken not to fuffer them
 to dry up, without opening others in their ftead.  Apoplectic per-
 fons ought never to go to reft with a full ftomach,  or to lie with
 their heads low, or wear any thing too tight about their necks. 
291
               CHAPTER   XLIV.


 Of  Coftivenefs,  and other  Aflfeclions  of the Stomach and
                          Bowels.

        WE do not here mean to treat of thofe aftrictions of the bow-
        els which are the  fymptoms of difeafes, as of the cholic,
 the iliac paffion, &c.  but  only to  take notice of that infrequency
 of ftools which fometimes happens, and which in fome particular
 conftitutions may occafion difeafes.
   CoftiveneSs may  proceed  Srom drinking rough red  wines,  or
 other aftringent liquor6 5  too much exerciSe, eSpecially on horfe-
 back. or Srom a long uSe of cold infipid food, which does not Suffi-
 ciently ftimulate the inteftines.  Sometimes it is owing to the bile
 not deScending to the  inteftines, as in the jaundice ;  and  at other
 times it proceeds Srom diSeafes oS  the inteftines themfelves, as  a
 palSy, SpaSms, torpor,  tumours oS the inteftines, &c.
   Exceffive coftiveneSs is apt  to occafion pains of the head, vomit-
 ing, colics, and other complaints of the bowels.  It is peculiarly
 hurtful to hypochondriac and hyfteric perfons, as it generates
 wind and other grievous fymptoms. Some people can bear coftive-
 nefs to a great degree.  I know  perSons who erijoy pretty good
 health, yet do not go  to Stool  above once a-week, and others not
 above once a-Sortnight. I have heard oS Some who do not go above
 once a-month.
  PerSons who are  generally coftive Should live upon a moiften-
 ing and laxative diet,  as  roafted  or boiled apples, pears, Slewed
 prunes, raifins, gruels with currants, butter, honey, Sugar, and
 fuch-like. Broths with fpinage, leeks,  and other SoSt pot-herbs,
 are likewiSe  proper. Rye-bread, or that which is made of a mix-
 ture of wheat and rye together, ought  to be eaten.  No  perSon
 troubled with coftiveneSs fhould eat white bread alone, eSpecially
 that which is made of fine flour. The heft bread for keeping the
 body foluble is what in fome parts of England they call meflin.  It
 is made oS a mixture  of wheat and rye, and is very agreeable  to
 thofe accuftomed to it.
  Coftivenefs is encreaSed  by keeping the body too warm, and by
 every thing  that  promotes the perSpiration ; as wearing flannel,
 lying too long a-bed,  &c.   IntenSe thought and a Sedentary life,
 are likewiSe hurtful. All the fecretions and excretions are  promo-
ted by moderate exercife without  doors, and by  a gay, cheerful,
fprightly temper of mind.
  The drink fliould  be of an opening quality. Ardent fpirits, auf-
tere and aftringent wines,  as port, claret, &c. ought to be  avoi-
ded. Malt-liquor that  is fine,  and  of a moderate Strength, is very 
292
WANT OF APPETITE.
p: per. Butter-milk, whey, and other watery liquors, are likewife
proper, and may be drank in turns, as inclination directs.
  Thofe troubled with coftiveneSs, ought, iS poffible,  to remedy
it by dfet, as the conftant ufe of medicines Sor that purpofe is at-
tend*.; 1 with many inconveniencies, and oSten with bad confequen-
ces*  1 never knew  any one get into a habit oS taking medicine
for keeping the body open, who could leave it off.  In  time, the
cuftom becomes neceffary, and generally ends in a total relaxation
oS tiie bowels, indigeftion, loSs oS appetite, wafting of the ftrength,
and death.
   When the body cannot be kept open without medicine, we re-
commend gentle dofes ot caflor-oil, flour of fulphur, and cream
of tartar, to be taken twice or thrice a-week.  This is  not near fo
injurious to the ftomach as aloes, jalap, or the other draftic  pur-
gatives fo much in ufe. Infufions of fenna and manna  may like-
wiSe be taken, or half an ounce of foluble tartar diffolved in water-
gruel   About  the  Size 6i a  nutmeg of lenitive  electuary taken
twice or thrice a-day generally anfwers the purpofe very well.
                     Want of Appetite.


   THIS may proceed from a foul ftomach; indigeftion ;  the want
of Sree  air and exerciSe ; grieS;  fear ; anxiety ; or any oS the de-
preffing paffions ; exceffive  heat; the uSe of ftrong broths, Sat
meats, or any thing that palls the appetite, or is hard  oS digeftion;
the immoderate ufe oS ftrong liquors, tea, tobacco, opium, &c.
   The  patient  ought, if impoflible, to make choice of an open dry
air; to take exercife daily on horfeback or  in a carriage; to rife

  •fc Dr- Arbuthnot advifes thofe who  are troubled with coftivenefs to
life animal oils, as frefh butter,  cream, marrow, fat broths, efpecially
thofe made of internal parts of animals,  as the liver, heart, midriff",
&c. the  expreffed oils of mild vegetables, as olives, almonds, paftaches,
and the  fruits themfelves; all oily and mild fruits, as figs ; decoctions
of mealy vegetables;  thefe lubricate the inteftines ;  fame faponaceous
fubftances which ftimulate gently, as honey, hydromel, or boiled honey
and water, unrefined fugar, &c.
  He obferves, that fuch lenitive fubftances- are proper  for perfons of
dry atrabilarian conftitutions, who are fubject to aftriction of the belly,
and the  piles, and will operate when ftrongcr medicinal fubftance.} are
fometimes ineffectual ; but that fuch  lenitive diet hurts thofe whofe
bowels are weak and  lax.  He obferves, that all watery fubftances are
lenitive, and that even common water, whey,  four  milk, and butter
milk have that effeft ;—that new milk, efpecially aifes milk, ftimulates
ftii' more when it fours on the ftomach ; and that whey turned four
will purse ftrongly ;—that n.oft garden fruits are likewife  laxative;
and that fome of them, as grapes, will throw fuch as take them immt'
derately into a cholera morbus, or incurable diarrhoea. 
                THE HEART-BURN.              ^9%

betimes ; and to avoid all intenfe thought. He fhould ufe a diet of
eafy digeiiion ;  and avoid exceffive heat and Satigue.
  If want of appetite proceeds  from errors in diet,  or any other
part^of the patient's  regimen,  it ought to be changed. If naufea
and rollings thew that the ftomach is loaded with crudities, a vo-
mit will be ol fervice. After this a gentle purge or two, of any of
the bitter purging falts, may be taken.  The patient  ought next to
uSe fome oi the ftomachic bitters infufed in wine. Though gentle
evacuations be  necelfary, yet  ftrong  purges and vomits are to be
avoided, as they weaken the ftomach, and hurt digeftion.
   Elixir of vitriol is an excellent medicine in moft cafes of indigef-
tion, weaknefs ot the ftomach, or want of appetite.  From twenty
to thirty drops of it may be taken twice or thrice a-day in a glafs
of wine and water. It may likewife be mixed with the tincture of
the bark, one dr.-.chm of the former to an ounce of the latter, and
two tea-fpoonfuls  of it taken in wine or water, as above.
   The chalybeate waters, if drank in moderation, are generally
 of confiderable fervice in this cafe. The fait water has  likewife
good effects, but muft not be ufed too freely. The waters of Har-
rowgate, Scarborough, Moffat,  and moft other Spas  in Britain,
may be ufed with  advantage.  All who are afflicted  with indigef-
tion and want  oS appetite, Should repair to theSe places oS public
 rendezvous. The very change oS air, and the  cheerSul company,
 will be oS  Service; not to mention the exerciSe, diffipation, amufe-
 ments, &c.
                     The Heart-Burn,

  AS it is commonly  called, is not a diSeaSe of that organ,  but
an uneaSy SenSation of heat or acrimony about the pit of the fto-
mach, which is fometimes attended with anxiety, naufea, and vo-
miting.
  It may proceed from debility of the ftomach, indigeftion, bile,
the abounding of an acid in the ftomach, &c.  Perfons  liable to
this complaint ought to avoid ftale liouors, acids,-windy or greafy
aliments, and fhould never ufe violent exercife foon after a plen-
tiful meal.  Many perfons have the heart-burn if they ride foon af-
ter dinner,  provided they have drank ale, wine, or any fermented
liquor ; but are never troubled with it when they have drank rum,
or brandy and water without any fugar or acid.
  When the heart-bum proceeds from debility of the ftomach, qr
indigeftion,  the patient ought to  take a dofe or two of rhubarb ;
afterwards he  may uSe infufions of the bark, or any other of  the
ftomachic bitters, in wine or brandy. Exercife in the open  air
will be of uSe, and every thing that promotes digeftion. 
ac)4
NERVOUS DISEASES.
   When bilious humours occafion the heart-burn, a  tea-fpoonful
of the fweet fpirit of nitre in a glafs of water, or a cup of tea, will
generally give eafe.  If it proceeds from the ufe of greafy aliments,
a drachm of brandy or rum may be taken.
   If acidity or fosirnefs of the ftomach occafions the heart-burn,
abforbents are the proper medicines. In this cafe, an ounce of pow-
dered chalk, half an  ounce of fine  fugar, and a quarter of an ounce
of gum-arabic,  may be mixed in an Englifh quart of water, and a
tea-cupful of it taken as often as is neceffary. Such as do not choofe
chalk may take a tea-fpoonful of prepared oyfter-fhells,  or  of the
powder called crabs-eyes, in a glaSs oS cinnamon or  pepper-mint
water. But the  SaSeft and beft abSorbent is magnefa alba. This not
only acts as  an  abSorbent, but likewiSe as a purgative  ; whereas
chalk and other abforbents of that kind, are apt to lie in the intef-
ftines and occafion obstructions. This powder is not difagreeable,
and may bs taken in a cup oStea, or a glaSs oS mint-water. A large
tea-Spoonful is the ufual dofe ; but it may be taken in a much great-
er quantity when there is occafion. Thefe things are now generally
made  up into lozenges for the conveniency of being carried in the
pocket, and taken at pleafure.                            ,
  If wind caufes  this complaint,  the moft proper medicines are
carminatives ; as annifeeds, juniper-berries, ginger, canella alba,
canfcmon feeds, &c. Thefe  may either be chewed, or  infufed in
wine, brandy, or other fpirits. One of the fafeft medicines of this
kind is the tincture  made by infufing an ounce of rhubarb, and a
quarter  of  an ounce of the leffer  cardamon feeds, in an Englifh
pint of brandy.  After this has digefted for two or three days, it
ought to be ftrained, and four ounces of white fugar-candy added
to it. It muft Stand to digeft a fecond time  till the fugar  be diffolv-
ed. A table-fpooful of it may be taken occafionally for a dofe.
  I have frequently known the heart-burn cured, particularly  in
pregnant women, by chewing green tea.
               CHAPTER   XLV.

                     Nervous Difeafes

      ARE, of all thofe incident to mankind, the moft complicated
      and difficult to cure. A volume would not be fufficient to
point out their various appearances. They imitate almoft every dif-
eafe ; and are feldom alike in two different perfons, or even in the
fame perfon at different times. They arecontinually changingfhape;
and upon every frefh attack, the patient thinks he feels fymp-
toms  which he never experienced before. Nor do they only affect
the body; the mind likewife fuffers, and is often rendered extreme-
ly weak aud peevifli. Ihe low fpirits, timoroufnefs, melancholy, 
                NERVOUS DISEASES.            295

and ftcklenefs of temper, which generally attend  nervous disor-
ders, induce many to believe that they are entfrely diSeaSes oS the
mind ; but this change oS temper is rather a conSequence, than
the cauSe oS nervous diSeaSes.
   CAUSES.----Every thing that tends to relax or weaken the*
body, diSpoSes it to nervous diSeaSes, as indolence, exceffive vene-
ry, drinking  too much tea, or other weak watery liquors warm,
Srequent and  copious bleeding, purging, vomiting, Sec. Whatever
hurts  the digeftion, or prevents the proper affimiiation of the Sood
has likewiSe this effect;  as long Safting,  excels in eating or drink-
ing, the uSe of windy, crude, or unwholefome aliments, an unfa-
vourable pofture of the body, &c.
   Nervous diforders often proceed from intenfe application to
ftudy.  Few ftudious perfons are entirely free from them. Nor is
this to be wondered  at;  intenfe thinking not only preys upon the
fpirits, but prevents the perfon from taking proper exercife, by
which means  the digeftion is impaired,  the nouriihme:,i preven-
ted, and the folids relaxed. Grief and disappointment likewiSe pro-
duce  the Same  effects.  More nervous  patients date  the com-
mencement of their diforders from the lofe of a hufband, a favou-
rite child, or from fome difappointment in life, than  from  any
other  caufe.  Whatever weakens the body, or deprefles  the fpirits,
may occafion nervous diforders, «s  unwholefome air, want of
fleep,  great fatigue, difagreeable apprehenfions, anxiety, vexation,
&c.
   SYMPTOMS----We  fhall only  mention fome of the moft
general fymptoms of thefe diforders, as  it would be both an ufe-
lefs and an endlefs tafk to enumerate  the whole.  They generally
begin" with windy inflations or diftentions of the ftomach and in-
teftines ; the appetite and digeftion are ufually bad ; yet fometimes
there  is an uncommon craving for  food, and a quick digeftion.
The food often turns four on the ftomach; and the patient is
troubled with vomiting of clear water, tough phlegm, or a black-
ifh-coloured liquor, refembling the grounds of coffee.  Excruci-
ating pains are often felt about the navel,  attended with a rumbling
or murmuring noife in the bowels.  The body is fometimes loofe,
but more commonly bound, which oecafions a retention of wind
and greac uneafineSs.
   The urine  is  Sometimes in Small quantity, at other times very
copious and quite clear. There is a great ftraitneSs of the breaft,
with difficulty of breathing ; violent palpitations of the heart;
fudden flufhings.of heat  in various  parts oS the body; at other
times  a SenSe of cold, as if water were poured on them ; flying
pains  in the arms and limbs;  pains in the back and belly, refem-
bling thofe occafioned by gravel; the pulSe very variable, Some-
times  uncommonly flow, and at other times very quick; yawning,
the hiccup, frequent fighing, and a fenfe.of fuflbcation, as if from
a baH or lump in the throat;  alternate fits of crying and conjul- 
. a96           NERVOUS DISEASES.

  five laughing ; the fleep is  unSound and Seldom refrefhing; th«
  patient is oSten troubled with the night-mare.
    As the diSeaSe increafes, the patient is molefted \\ ith head-achs,
  cramps, and fixed pains in various parts of the body ; the eyes are
  clouded, and  oSten affected with  pain  and dryneSs ; there is a
  noiSe in the ears, and  often a dulnefs of hearing; in fhort, the
  whole animal functions are impaired.   t he mind is difturbed on
  the  moft trivial occafions, and is hurried into the moft perverfe
  commotions,  inquietudes, terror, fadnefs, anger, diffidence, &c.
  Tiie patient is apt to entertain wild imaginations and extravagant
  fancies; the memory becomes weak, and the judgment fails.
    Nothing  is more "characteriftic  of this difeafe than a conftant
  dread of death.  This renders  thofe unhappy perfons who labour
* under it, peevifh, fickle, impatient, and  apt to run from one phyfi-
  cian to  another; which is one reafon why they feldom  reap any
  benefit  from  medicine, as they  have not fufficient refolution fo
  perfilt in any one courfe till  it  has time  to produce its proper ef-
  fects.  They are likewife apt to imagine that they labour under
  diSeaSes Srom which  they are  quite Sree ;  and  are  very angry
  iS any one attempts to Set them right, or laugh them out oS their
  notions.
    REGIMEN.----PerSons afflicteft with nervous diSeafes ought
  never to fait long.  Their foed fliould be Solid and nourifhing, but
  of eafy digeftion. Fat meats  and heavy fauSes are hurtSul. Allex-
  ceSs fhould be  careSulIy avoided.  They ought never to eat more at
  a time than they can eafily digeft ; but iS they Seel themfelves weak
  and  faint between meals, they ought to eat a bit of bread, and drink
  a glaSs oS wine.  Heavy Suppers are to be avoided.   Though wine
  in exceSs enSeebles the body,  and impairs the faculties oS the mind,
  yet taken in moderation, it Strengthens the ftomach, and promotes
  digeftion. Wine and water h a very proper drink at meals ; but if
  wine fours on the ftomach, or the patient is  much troubled with
  wind, brandy  and  water will anfwer better.  Every thing that is
  windy or hard of digeftion muft  be avoided.  All weak and warm
  liquors are hurtful, as tea, coffee, punch, Sec. People may find a
 temporary relief in the ufe of thefe, but they always increaSe  the
  malady, as they weaken the  ftomach and hurt digeftion.  Above  j
 all things, drams are to be avoided.  Whatever immediate eaSe the  j
 patient may Seel Srom the uSe of ardent Spirits, they are  Sure to ag-  \
 gravate the malady, and prove certain poiSon at laft.   TheSe cau-
 tions are the more necefiary,  as moft nervous people are peculiarly  I
 fond of  tea and ardent fpirits ;  to the ufe of which many of them
 fall victims.
   Exercife in nervous diforders is fuperior to all medicines. Rid-
 ing on horfeback is generally efteemed the beft, as it gives motion
 to the whole body without fatiguing it.   I have known patients
 with whom walking agreed better, and others who were moft be-  \
 nefited by riding in a carriage.  Every one ought to ufe that which 
                  NERVOUS DISEASES.   ■          *>?

   he finds moft beneficial. Long Sea-voyages have an excellent ef-
   fect ; and to thofe who have Sufficient reSolution, we recommend
-  this courfe. Even change of place, and the fight of new objeas,
   by diverting  the mind, have  a great tendency to remove thefe
   complaints. For this  reafon, a long journey, or a voyage, is of
   much more advantage than riding fnort journeys near home.
     A cool and dry air is proper, as it braces and invigorates  the
   whole body.  Few things tend more to relax and enervate than
   hot air, eSpecially that which is rendered So by great fires, or ftoves
   in Small apartments.  But when the ftomach or bowels are weak,
^   the body ought to be  well guarded againft cold, eSpecially in win-
   ter, by wearing a thin flannel  waiftcoat next the fkin.  This will
   keep up an equal  perSpiration, and defend the alimentary canal
   from many impreffions to which it would otherwiSe be Subject,
   upon every Sudden change Srom warm to  cold weather.  Rub-
   bing the body Srequently  with a  flefli-brufh, or a  coarfe linen
   cloth, is heneficial, as it promotes the circulation, perSpiration,
   &c.   PerSons who have weak nerves ought to riSe early, and take
   exerciSe beSore breakSaft, as lying too long a-bed cannot fail to
   relax the Solids. They ought to be diverted, and kept as eafy and
   cheerful as poffible..  Nothing hurts the nervous fyftem, or weak-
   ens the digeftive powers, more than Sear, grief, or anxiety.
     MEDICINES..----Nervous difeafes are feldom radically cured,
   yet their fymptoms may fometimes be  alleviated, and life render-
   ed more comfortable  by proper medicines.
     When the patient  is coftive, he ought to take a little rhubarb,
   or fome other mild purgative,  and  fliould never Suffer his body to
   be long bound.  All ftrong and violent purgatives are  to be avoi-
   ded, as aloes, jalap, &c. I have generally Seen an inSufion of fen-
   na  and rhubarb in brandy anfwer  very well.   This may be made
   oS any ftrength, arid  taken in Such quantity as the patient finds
   neceffary.  When digeftion is bad, or the ftomach  relaxed and
   weak, the following  infufion  of  bark and other bitters may be
   ufed with advantage  :
      Take of Peruvian bark an ounce,  gentian-root, orange-peel,
   and coriander-feed, of each half an ounce ; let thefe ingredients
   be all bruifed in a mortar, and infufed in a  bottle of  brandy or
   whiflcey, for  the fpacc of five or  fix days.   A  table-Spoonful of
   the ftrained liquor maj be taken in half a glafs of water, an hous
   before breakfaft, dinner, and fupper.
      Few thing tend more to Strengthen the nervous Syftem than cold
   bathing. This practice, if duly perfifted in, will produce very ex-
   traordinary effects; but when the liver or other viSceraare obltruc-
   ted, or, pthcrwife unfound, the cold bath is improper.  It is there-
   fore to be uSed with  very great caution.  The moft proper feafona
   are fummer and autumn. It will  be fufficient, efpecially for per-
   fons of a fpare habit, to go into the cold bath three or four time*
P  2 
293                MELANCHOLY.             *

a week. If the patient be weakened by it, or feels chilly for a long
time after coming out,  it is improper.
  In patients afflicted with wind, I have always obferved the great-
eft benefit from the elixir of vitriol. It may be taken in the quan-
tity of fifteen, twenty, or thirty drops, twice or thrice a-day in a
glafs of water.  This both expels wind, Strengthens the ftomach,
and promotes digeftion.
  Opiates are generally extolled in thefe maladies;  but as they
only palliate the Symptoms, and  generally afterwards increaSe the
diSeaSe, we adviSe people to be extremely Sparing in the uSe oS them,
left habit render them at laft absolutely neceffary. '
  It would be an eafy matter to enumerate many medicines which
have been extolled Sor  relieving nervous  disorders;  but whoever
wifhes for a thorough  cure muft expect it from regimen alone;
we fhall thereSore omit mentioning more medicines, and again re-
commend the ftricteft attention to diet, air, exercife, and  amuSe-
inents.
                         Melancholy

  ' IS that ftate of alienation or weaknefs of mind which renders
people incapable of enjoying the pleafures, or perSorming the du-
ties of life.  It is a degree of infanity, and often terminates in ab-
folute madnefs.
   CAUSES.----It may proceed from an hereditary difpofition;
intenfe thinking, efpecially where the mind is long occupied about
one object;  violent paffions or affections of the mind, as love, fear,
joy, grief, overweening pride, and fuch-like.  It  may alfo be occa-
fioned by exceffive venery ; narcotic or ftupeSactive poiSons ; a Se-
dentary life  ; folitude ; the fuppreffion  of cuftomary evacuations;
acute fevers or other diSeaSes.   Violent anger wall change melan-
choly into madneSs; and exceffive cold, eSpecially of the lower ex-
tremities, will force the blood into the brain, and produce all the
fymptoms of madnefs.  It may likewife proceed from the ufe  of
aliment that is hard of digeftion, or which cannot be eafily afli-
milated, from a callous ftate of the integuments of the brain. To
all which, we may add gloomy, or mistaken notions of religion.
   SYMPTOMS.----When perfons begin to be melancholy, they
are timorous; watchful;  fond  of folitude;  fretful; captious
and inquifitive ; felicitous about trifles  ; fometimes niggardly, and
at other  times prodigal.  The body is generally bound ; the urina
thin,  and in fmall quantity; the ftomach and bowels inflated with
wind  ; the complexion pale ; the pulfe  flow and weak. The func-
tions  of the mind are alfo greatly perverted ;  the  patient often
imagines himSelf dead, or changed into fome other animal.  Some
have imagined their bodies were made of glafs, or other brittle 
                   MELANCHOLY.                 299

fubftances, and were afraid to move left they fliould be broken to
pieces. The patient, in this cafe, unlefs carefully watched, is apt
to put an end  to his own life.
  When the difeafe is owing tq an obftruction of cuftomary eva-
cuations, or any bodily  diforder, it is eafier cured  than when it
proceeds from affections of the mind, or any hereditary taint.  A
difeharge of blood from  the nofe, loofenefs, feabby eruptions, the
bleeding piles, or the menfes, fometimes carry off this difeafe.
  REGIMEN.----The diet fhould confift chiefly of vegetables
of a cooling and opening quality.  Animal  food, efpecially falted
or fmoke-dried fifh or flefh, ought to be  avoided.   All  kinds of
fhell-fifh are bad. Aliments prepared with onions, garlic,  or any
thing that generates thick blood, are likewife improper. All kinds
of fruits that are wholefome may be eaten with advantage. Boer-
haave gives an inftance  of a patient, who, by a long ufe of whey,
water, and garden fruit, recovered, after having evacuated a great
quantity of black-coloured matter.
  Strong liquors of every kind ought to be avoided as poifon.  The
moft proper drink is water, whey, or very fmall beer.  Tea and
coffee are knproper. . If honey agrees with the patient, it may be
eaten freely, or his drink may be fweetened with it. Infufions of
balm-leaves, penny-royal, the roots of wild  valerian, or the flow-
ers  of the lime-tree, may be drank freely, either by themfelves, or
fweetened with honey, as the patient fhall choofe.
  The patient ought to take as much exercife  in the open  air as
he can bear. This tends to remove "obstructions, promotes the per-
fpiration, and  all the other fecretions.  Every kind of madnefs. is
attended with a diminifhed perSpiration ; all means ought there-
fore to be ufed to promote that neceffary and  Salutary diScharge.
Nothing can have  a more direct tendency to increaSe the diSeaSe
than confining the'patient to a  cloSe apartment. Were he Sorced
to ride or walk a certain number of miles every day, it would tend
greatly to alleviate his diforder ; but it would have ftill a better
effect, if he were obliged to labour  a piece of ground.  By dig-
ging, hoeing, planting, Sowing, &c.both the body and mind'would
be exerciSed.  A long journey, or a voyage, efpecially towards 3
warmer climate, with agreeable companions, has oSten very happy
effects.   A  plan of this  kind, with a" ftri£t attention  to diet, is a
much more  rational method of cure,  than confining the  patient
within doors and plying him with medicines.
  MEDICINE-----In the cure of this diSeaSe, particular atten-
tion muft be paid to the  mind.  When the patient is in a low
ftate, his mind ought to be foothed and diverted with variety of
amuSements, as entertaining  ftories, paftimes, mufic, &c.  This
Seems to have been the method of curing melancholy among the
Jews, as we learn from  the ftory of Saul; and it is a very ration-
al one.  Nothing can remove difeaSes oS the mind  So effectually,
as applications to the mind itSelf, f>e moft efficacious of which is 
 jes               MELANCHOLY.

 mufic.  The patient's company ought likewife to confift of fuch
 perSons as are agreeable  to him.  People in this ftate are apt to
 conceive unaccountable averfions againft particular perSons ;  and
 the very fight oS Such perSons is Sufficient to diffract their minds,
 and throw them into the utmoft perturbation.
   When the  patient is high, evacuations are necefiary.   In  this
 caSe, he muft be  bled,  and have his body kept open by purging
 medicines, as manna, cream oS tartar, or the Soluble tartar.  I have
 feen the laft have very happy effects.  It may be taken in the doSe
 of haJS an ounce, diffolved in water gruel, every day, for fundry
 weeks, or even for months, iS neceffary.  More or  leSs may be
 given according as it operates.  Vomits have likewiSe a good ef-
 fect ;  but they muft be pretty ftrong, othcrwife they will not ope-
 rate.
   Whatever increafes the evacuation of  urine or promotes per-
 fpiration, has a tendency to remove this difeafe.   Both thefe fe-
 cretions may be promoted by the ufe  of nitre and vinegar. Haifa
 drachm of purified nitre may be  given three or four  times a-day
 in any manner that is moft agreeable  to the patient; and an ounce
 and a half of diftil'ed vinegar may be daily mixed with his  drink.
 Dr. Locker  feems to think vinegar the beft medicine that can be
 given in this difeafe.
   Camphire  and mufk have been ufed in this cafe with advantage.
 Ten  or twelve grains  of camphire  may be rubbed in a mortar,
 with half a drachm of nitre, and taken twice  a-day, or oftener, if
 the ftomach will bear it. If it will not fit upon the Stomach in this
 form, it may be made into  pills v/ith gum afafcetida and Ruffian
 caftor, and taken in the  quantity above directed.  If mufk is to be
 adminiftered, a Scruple or twenty-five grains of it may be made
 into a bolus with a little honey or common fyrup, and taken twice
 or thrice a-day.  We do not mean that all thefe medicines mould
 be  adminiftered at once ;  but which  ever of them is given, muft
 be duly perfifted in, and where one fails, another may be tried. .
  As it is very difficult to induce patients, in this difeafe, to take
 medicines, we fhall mention a few outward applications, which
 fometimes do good ; the principal of thefe are iffues,  fetons, and
 warm bathing. Iffues may be made in any part of the body, but
 they generally have the beft effect near the Spine.  The difeharge
 from thefe, may be greatly promoted, by  dreffing them with the
 mild bliftering ointment, and keeping what are commonly called
the orrice peafe in them. The molt proper place for.a feton is be-
 tween the fhoulder-blades ; and it ought  to  be  placed upwards
 and downwards, or in the direction of the fpihe. 
301
                           The Palfy

    IS a lofs  or diminution of  fenfe or  motion,  or  of  both,
 in one or more  parts of  the  body.  Of all the affections called
 nervous,  this is the moft Suddenly Satal.  It is more or leSs dan-
 gerous, according to the importance of the part affected.  A palfy
 of the heart, lungs, or any part neceffary to life, is mortal.  When
 it affects the  ftomach, the  inteftines,  or the bladder, it is highly
 dangerous.   If the  face be affected,  the cafe is bad, as it fhows
 that the difeafe proceeds from the brain.  When the part  affected
 feels cold, is infenfible, or wattes away, or when the judgment and
 memory begin to fail, there is fmall hope of a cure.
    CAUSES.----The immediate  caufe of palfy is  any thing that
 prevents the regular exertion of the nervous power  upon any par-
 ticular mufcle or part of the body. The occafional and predifpo-
 fing cauSes are various, as  drunkenneSs ; wounds of the brain, or
 fpinal marrow,  preffure upon the brain or nerves ; very cold or
 damp air ; the fuppreffion of cuftomary evacuations ; fudden fear;
 want of exercife ; or whatever greatly relaxes the fyftem, as drink-
 ing much  tea*, or coffee,  &c.  The palfy  may likewife proceed
 from wounds of the nerves  themSelves, Srom the poiSonous fumes
 of metals or minerals, as mercury, lead, arfnic.
   In young perSons of a full habit, the palfy muft be treated in  the
 fame manner  as the fanguine apoplexy. The patient mult be bled,
 bliftered, and  have his body opened by  fharp clyfters or  purgative
 medicines.  But, in old age, or when the difeafe proceeds Srom  re-
 laxation or debility, which is generally the caSe, a quite contrary
 courSe muft be purSued.  The diet muft be warm and invigorating,
 feaSoned with Spicy and aromatic vegetables, as muftard, horSe-ra-
 difh, &c. The drink may be generous wine, muftard,  whey, or
 brandy and water. Friction with the flefh-brufh, or a warm hand,
 is extremely proper,  eSpecially on the parts affected. Blifters may
 likewiSe  be applied  to the affected parts with advantage. When
 this  cannot be done,  they may be rubbed with  the volatile lini-
 ment, or the nerve ointment of the Edinburgh difpenfatory. One
 of the beft external applications is electricity. The  fiiodkg, or  ra-
 ther vibrations,  Should be received on the part affected ;  and they
 ought daily to be repeated for feveral weeks.
   Cephalic fnuff, or any thing that makes the patient Sneeze, is

  * Many people imagine, that tea has no  tendency to hurt the nerves,
 and that drinking the fame quantity of warm water would be  equally
 pernicious.  This, however, feems to be a  miftake. .Many perfons drink
 three or four cups of warm milk and water daily, without feeling any
 bad confequences ; yet the fame quantity  of tea will make their hands
 fliake for twenty-four hours. That tea affects the nerves, is-likewife
evident, from its preventing fleep, occafioninggiddinefs, dimnefs of the
fight, ficknefs, &c, 
3o2                  TETANUS.

likewife of ufe. Some pretend to have  found great benefit from
rubbing the parts affected with nettles ; but this does not feem to
be any way preferable to bliftering. If the tongue is affected, the
patient may gargle his mouth frequently with brandy and muftard;
or he may hold a bit of fugar in his  mouth  wet with  compound
fpirits of lavender.  The wild valerian-root is a very proper medi-
cine in this cafe. It may either be taken in an infufion with fage-
leaves, or half a drachm of it in powder may be given in a glafs of
wine three times a-day. If the patient cannot ufe the valerian, he
may take offal volatile oleofum, compound fpirits of lavender,  and
tincture of caftor, each half an ounce ; mix  thefe together, and
take forty or fifty drops in a glafs of wine three or four times a-day.
A table-fpoonful of muftard-feed taken frequently is a very good
medicine.  The patient ought likewife to chew  cinnamon-bark,
ginger or other warm fpiceries.
   Exercife is oSthe utmoft importance in the palfy ; but the pa-
tient muft beware of cold, damp, and moift air. He ought to wear
flannel next  his fkin ;  and  if poffible, Should remove into a war-
mer climate.
              Tetanus,  or the Locked-jfaiu.

  UNDER this term may be comprehended the SpaSmodic af-
fections,  called emprofthotonos,  opifthotonos,  and  triSmus, be-
ing one diSeaSe, differing only in the degree of its violence. When
the body  and head are bended forwards, it is called emprofthoto-
nos; when they^are carried backwards, and immovably fixed, it
bears the appellation  of opifthotonos ; and when the body is fuf-
tained in an erect  pofition, by  the mufclc on the Sore and back
partoS the trunk acting with equal ftrength, the diSeafe is called
tetanus.  When the muSeles of the jaw become more particularly
affected,  it is called trifmus, or locked jaw.
   Thefe  SpaSmodic complaints affect both Sexes, and no age is ex-
empted from their violence. They affect the male oStener than the
female,  and more particularly thoSe people who inhabit warm
climates, and every climate'at the warm SeaSon of the year. Some-
times they occur in winter, independent of wounds.
   CAUSES.----Wounds in any part of the body are fomettmes
fucceeded by  this difeafe.  But more particularly from thofe hi
tendons, where a  trifling  injury will not unfrequently produce
this  complaint, when it is leaft expected. Whereas, at other times,
a wound of confiderable magnitude, under apparently Similar cir-
cumftances, will have no Such effect; and, even aSter operations
in tendenous parts, it is by no means a Srequent occurrence ; when
at other  thnrs, a fimple fracture of  the leg  will produce it in all 
                        TETANUS.                   303

 its Sorce.  Cold, when accompanied with moifture, will produce
 this diSeaSe ; particularly when the body is expoSed while afleep,
 on a damp pavement, or in a damp cellar, immediately aSter be-
 ing heated and fatigued by exercife.  Children  are  frequently
 feized with this diSeaSe in a fhort time after delivery.
   SYMPTOMS.—-This difeafe, iSit is Srom the effeas of cold,
 generally comes on of a Sudden. But when Srom a wound, it gra-
 dually approaches about the tenth, Sourteenth, or twentieth days
 aSter the accident.   It oSten comes on  at a time when the wound
 gives but little uneafineSs, and  is nearly healed.  The patient firft
 complains of an uneaSy fenSation at the lower part oS the breaft
 bone, with a StiffneSs in the back part of the neck and mufcles, of
 the lower jaw,  which increafe  with a painful fenfation at the root
 of the tongue, and a flight difficulty in fwallowing. But no appear-
 ance of fwelling can be  obferved in the throat.  The mufcles of
 the back uow become rigid. This rigidity in a fhort time extends to
 thofe of the neck, attended with a pain  in the  direction of the
 fpine of the back.  At length the head, neck, and back bone arc
 forcibly bent backwards.  The body becomes fixed in that pofition.
 The mufcles of the jaw are now violently affected, attended with
 an impoffibility of fwallowing.  Even liquids are thrown forcibly
 back through the nofe.  Thefe fymptoms generally ta'ke place on
 the fecond or third day, when the  body is frequently feized with
 violent  convulfive fpafms;  and the pain at the lower part  of the
 breaft bone increafes, which fhoots through towards the back.
   The  mufcles of the limbs now become rigid, and the body is fo
 much bent backwards as to reft on the back part of the head ^and
 heels. As the difeafe advances, the convulfive fpafms become more
 violent.   At length tetanus is produced, from  the mufcles on the
 fore and back  part of the  trunk, acting with an equal degree of
 vigour, fuftaining the body in an erect  pofition. The pulfe is ge-
 i;crally  frequent  with the other fymptoms of  fever, particularly
 when the difeafe is the confequence of cold.  The bowels are ge-
 nerally coftive, attended with a retraction of the belly.  The urine
 is difcha.rged with difficulty, and fometimes a fuppreffion of that
 evacuation takes place. The face appears pale, expreffive of great
 anxiety and diftrefs. The patient is Seldom, if ever, delirious, al-
 though he numbers but little, from which he frequently awakes on
 a Sudden, v/ith violent SpaSms.  At length, the muScular  Syftem be-
 comes more generally affected, and one  univerfal convulfion clofes
 the miferable exiftence of the patient.
   MEDICINE.----In our attempt  to cure this difeaSe, the indi-
 cations are nearly the Same, when produced Srom cold or the confe-
 quence oS a wound, except when  the wound is without  Swelling
 and inflammation.  It fhould then be  dilated and dreffe.l, with lint
 dipped in warm bafilicon, or any other Stimulating application. Af-
 ter this, two, three, or even four grains  of  opium fhould be givea
tlirce or four times 8 day,   according to the urgency of the Syrup- 
3°4
THE EPILEPSY, Sec.
toms, and tendency to induce fleep ; for aftonifhingqunntities of this
medicine may be given without having the leaft tendency to make
the patient number. This remedy fhould be adminiftered early, as
well as large quantities of Madeira wine, before the fwallowing be-
comes interrupted; and the fyftem fhould be charged with mercury,
with as much expedition as poffible.  For this purpoSe, two or three
drachms of mercurial  ointment muft be rubbed  into the infide of
the legs, thighs, and arms, morning and evening, and likewife into
the mufcles more particularly affected with fpafms. To co-operate
with  thofe medicines, the cold bath muft be uSed, or cold water
thrown  over the body. The bowels fliould be kept open with calo-
mel, caftor-oil, and clyfters.  All thoSe remedies muft be uSed at an
early  period of the  complaint, fo as to make as formidable an attack
as poffible on this very formidable difeafe, which too  frequently
terminates in the death of the patient, in fpite of every effort to Save
him.
   When it is about to take place in  infants,  the bowels muft be
opened with calomel or caftor  oil. But where it has actually taken
place, little can be done.  However,  a fimilar plan may be ufed
with  that  recommended in ^rown perfons.

                          —■ -«-c£22jsj——*

              Of the Epilepfy or Falling Sicknefs.

   THE epilepfy is a fudden deprivation of all the fenfes, wherein
the patient falls fuddenly down, and is affected with violent convul-
five motions.  Children, efpecially thofe who are delicately brought
up, are moft fubject to it.  It more  frequently attacks men than wo-
men, and  is very difficult to cure. When the epilepfy attacks chil-
dren, there  is reafon  to hope  that it will go off about the time of
puberty. When it  attacks any perfon after twenty years of age, the
cure is difficult; but when after forty, a cure is hardly to be expec-
ted.  If the fit continues only for a fhort fpace, and returns Seldom,
there is reaSon to hope; but if it  continues long,and returns Srequent-
ly, the proSpect is bad. It is a very unfavourable fymptom when the
patient is feized with the fits in his fleep.
   CAUSES.----The epilepfy is fometimes hereditary. It  may
likewife proceed from blows,  bruifes, or wounds on  the head;  a
collection of water, blood, or ferous humours in the brain ; a poly-
pus ;  tumours or concretions within the fkull; exceffive drinking;
intenfe  ftudy; excefs of yenery ; worms ;  teething ;  fuppreffion
of cuftomary evacuations ; too great emptinefs or repletion ; vio-
lent paffions or affections oSthe mind, as fear, joy, &c ;  hyfteric oi-
fections;  contagion received into thebodv, as tie infection of the
ftnall-pox, meafles, &c. 
                     THE EPILEPSY, &c.              305
                                                          IT. Ill «
    SYMPTOMS.----An epileptic fit is generally preceded by un*
 ■ufual wearinefs ; pain of the head ; dullnel's; giddinefs; noife in the
 ears ; dimnefs of fight; palpitation of the  heart; difturbed  fleep j
 difficult breathing ; the bowels are inflated with wdnd ; the urine is
 in great quantity, but thin;  the  complexion is pale; the extremi-
 ties are cold ; and the patient often feels, as it were, a'ftream of coid
 air afcending towards his head.
    In the  fit, the patient  generally  makes an linufual noife ; his
 thumbs are drawn in towards the palms of his hands ;  his eyes are
 diftorted;  he  Starts, and Soams at the  mouth; his extremities are
 bent or twifted various ways ; he often difcharges his feed,  urine,
 ;md fasces involuntarily ; and is quite deftitute of all fenfe and rea-
 fon.  After the fit  is over, his fenfes gradually return, and he com-
 plains of a kind of ftupor, wearinefs, and pain of his head  ; but has
 no remembrance of what happened to him during the fit.
   The fits are fometimes excited by violent affections of the mind,
 a debauch of liquor, exceffive heat, cold, or the like.
   This difeafe, Srom the difficulty of inveftigating its caufes, and its
 Strange fymptoms, was formerly attributed to the wrath of the gods,
 or the agency of evil fpirits. In modern times  it has often, by  the
 vulgar, been imputed to witchcraft.  It depends as much upon na-
 tural caufes as any other malady ; and  its cure may often be effec-
 ted by perfifting in the ufe of proper means.
   REGIMEN.----Epileptic patients ought, if poffible, to breathe
 a pure and free air. Their diet fhould be light but nourifhing.  Th :y
 ought to drink nothing ftrong, to avoid fwine's flefh, water fowl,
 and likewife all windy and oily vegetables, as cabbage,  nuts,  &c;
 They ought to keep themfelves cheerSul, carefully guarding againft
 all violent paffions, as anger, tear, exceffive joy, and the like.
   Exercife  is likewife of great ufe ; but the patient muft be careful
 to avoid all  extremes either of heat or cold, all dangerous fituations,
 as ftanding  upon precipices, riding, deep waters, and fuch  like.
   MEDICINE.----The intcntious of cure  muft vary  according
 to fhe caufe of the difeaSe.  If the parent be oS a Sanguine tempera-
 ment,  and there be reaSon to Sear an obftruction in the brain, bleed-
 ing and other evacuations will be neceffary. When the difeafe is oc-
 cafioned  by  cuftomary evacuations, thefe, if poffible, muft be refto-
 red; if this cannot be done, others may be fubftituted in their place,
 Iffues or fetons in this cafe have  often a very good effect.  When
 there  is reafon  to believe that the difeafe proceeds from  worms,
 proper medicines  mult be uf-d to kill, or carry off theSe  vermin.
 When the diSeaSe proceeds Srom teething, the body fhould be kept
 open by emollient clyfters,  the Seet frequently bathed in warm wa-
 ter, and,  if the fits  prove obftiriate, a blifter may be put betwixt th©..
 ihoulders. The  fame method is to be followed, when epileptic fits
precede the eruption of the fmall-pox, or meafles, &c.
  Wnen the difeafe is hereditary,  or proceeds from a wrong forma-
tion of th.* brain, a cr.'.e is r.ot to be expedted,  When it is owing 
306                 THE HICCUP.
to a debility, or too great an Irritability of the nervous Syftem, Such
medicines as tend to brace and ftrengthen the nerves may be uSed,
as the Peruvian bark,  fteel, &c.
   The flowers of zinc  have of late been highly extolled for the cure
of the epilepfy. This  medicine will not  anfwer the expectations
which  have been raifed concerning it, yet in obftinate epileptic ca-
fes, it deferves a trial.  The dofe is from one to three or four grains,
which may be taken either  in pills or a bolus, as the patient inclines.
The beft method is to begin with a fingle grain four or five  times
a-day, and gradually to increafe die dofe as far as  die patient can
bear it.  I have known this medicine, when duly perfifted in, prove
beneficial.
   Mufk has fometimes been found to fucceed in the epilepfy. Ten
or twelve grains of it,  with the fame quantity of factitious cinna-
bar,  may be  made up  into a bolus,  and taken every night and
morning.
   Sometimes the epilepfy has been cured  by electricity.
   Convulfion-fits proceed  from the fame caufes, and muft be treat-
ed in the fame manner as the epilepfy.
   There is one particular Species oS convulfion-fits which common-
ly goes by the name  oS St.  Vitus's dance,  wherein die patient is
agitated with Strange motions and gefticulations, which, by the com-
mon people, are generally  believed to be  the effects of witchcraSt :
This diSeaSe may be cured by repeated bleedings aud purges ; and
afterwards ufing the medicines prefcribed above for the  epilepSy,
viz. the Peruvian bark and Snake-root, &c.  Chalybeate waters  are
found to be beneficial in  this  cafe.  The cold bath is likewife of An-
gular fervice, and ought  never to be neglected when the padent can
bear h.
                         The  Hiccup

  IS a SpaSmodic or convulfive  affection of the ftomach  and mi-
driff, arifing Srom any cauSe that irritates their nervous fibres.
  It may proceed Srom excels in eating  or drinking ;  from a hurt
of the ftomach; poifons ;  infiammations or fehirrous  tumours of
the ftomach, inteftines, bladder, midriff,  or the reft of the vifcera.
In  gangrenes, acute and malignant fevers, a hiccup is  often the
forerunner of death.
  "When the hiccup proceeds from the ufe of aliment that is flatu-
lent, or hard of digeftion,  a drai:r;ht of generous wine, or a drachm
of any fplrituous liquor, will generally remove it. If poifon be the
caufe, plenty of milk and oil muft be drank, as has been formerly
recommended.  When it proceeds from an inflammation of the fto-
mach,  &c. it is very dangerous. In this cafe, the cooling  regimen
•ught to be fhictly obferved.  The patient muft be bled, and take 
CRAMP  OF THE STOMACH.
frequently a few drops of the fweet fpirits of nitre in a cup of wine-
whey.  His ftomach fhould likewife be fomented with cloths dipped
in warm water, or have bladders, filled with warm milk and wa-
ter, applied to it.
  When the hiccup proceeds from a gangrene or mortification, die
bark, and other antifeptics, are  the only medicines which have a
chance to Succeed.  When it is a primary diSeaSe,  and proceeds Srom
a foul Stomach, loaded with a bilious humour, a gentle vomit and
purge, iS the patient be able to bear them, will be  oS Service.  IS it
ariSes from flatulencies, the carminative  medicines directed  for the
heart-burn  muft be ui.u.
  When the hiccup proves very obftinate, recourSe  muft fie had to
the moft powerSul aromatic and antiSpaSmodic medicines. The prin-
cipal oS theSe is mufk ;  fiSteen c* twenty grains oS which may be
made into a bolus, and repeated occafion ally.   Opiates are oS fer-
vice ; but they muft be uSed with caution. A bit oS  Sugar, dipped in
compound Spirits oS lavender, or the volatile aromatic  tincture, may
be taken frequently. External applications are Sometimes alSo bene-
ficial ;  as the ftomach plaifter, or a cataplaSm oS the Venice treacle
oS the Edinburgh or London diSpenSatory, applied  to the region of
the ftomach.
  I lately attended a patient who had almoft a conftant hiccup for
above nine  weeks.   It was Srequently ftopped by the uSe oS mufk,
opium, wine,  and  other cordial  ami antiSpaSmodic medicines, but
always returned.  Nothing gave the patient So much eaSe as brifk
Small-beer.  By drinking Sreely oS this, die hiccup was oSten kept off
for feveral days, which was  more than  could  be  done by the moft
powerSul medicines.  "Fhe patient was at length Seized with a vomit-
ing of blood, which foon put an end to his life. Upon opening the
body, a large fehirrous tumour was found near the pylorus or right
©rifice of the Stomach.
                   Cramp of the Stomach.

  THIS diSeaSe  often feizes people fuddenly, is very dangerous,
and requires immediate affiftance.  It is moft incident to perfons in
the decline of life, efpecially the nervous, gouty, hyfteric, and hypo-
chondriac.
  If the patient has any inclination to vomit, he ought to take fome
draughts of warm water, or weak camomile-tea, to cleanfe his fto»
mach.  After this, if he has been coftive, a laxative  clyfter may be
given.  He ought then to take laudanum. The beft way of adminif
tering it is in a clyfter.   Sixty or Seventy drops oS liquid laudanum
may bo given in a clyfter of warm water.   This is much snore cer- 
.308              THE NIGHT-MARE.

tain than laudanum given by the mouth,  which is often vomited,
and in fome cafes, increafes  the pain and fpafms in the ftomach*.
   If the pain and cramps return with great violence, after the effects
of the anodyne clyfter are over, another, with an equal or a larger
quantity of opium, may be given ; and every four or five  hours a
bolus, with ten or twelve grains of mufk,  and half a drachm of die
Venice treacle.
   In the mean time, the ftomach ought to be fomented with cloths
dipped in warm water, or bladders, filled with warm milk and wa-
ter, fhould be conftantly applied to itf. I have often feen thefe pro-
duce  the moft happy effects.  The anodyne balfam may alfo be rub-
bed on the part affected ; and an antihyfteric plaifter worn  upon  it
for forfie time after  the cramps are removed, to prevent their re-
turn.
   In  very violent and lafting  pains of the ftomach, fome blood ought
to be let,  unlefs the weaknefs of the patient forbids it. When the
pain or cramps proceed from a fuppreffion of the menfes, bleeding
Is of  ufe.   IS they be owing to the gout, recourfe muft be had to
fpirits, or  fome oS the warm cordial waters. Blifters ought likewiSe,
in this caSe, to be applied to the ancles.   I have  often feen  violent
cramps and pains of the ftomach  removed, by covering it with a
large  plaifter  of Venice treacle.
                    Of the Night-Mare.

  IN this difeafe, the patient, in time of fleep, imagines he feels an ur.
uommon oppreffion or weight about his breaft or ftomach, which he
can byno means fhake off. He groans,and fometimes cries out, though
oftner he attempts to fpeak in vain.  Sometimes he imagines him-
felf engaged with an enemy, and in danger of being killed, attempts
to run away, but finds he cannot.  Sometimes he fancies himfelf
in a houfe that is on fire, or that he is in danger of being drowned
in a "river.  He often thinks he is falling over a precipice, and the
dread of being dafhed to pieces fuddenly awakes him.
  This diforder has been SuppoSed to proceed from too much  blood-:
from  a ftagnation of blood in the  brain, lungs,  &c.  But it is rather
a nervous affection, and arifes chiefly from indigeftion. Perfons of
weak  nerves,  who lead a fedentary life, and live full, are moft com-
monly afflicted with the night-mare.  Nothing tends more to pro-
duce it  than  heavy fuppers, efpecially when eaten late, or the pa-
tient goes to bed foon after. W hid is a very frequent caufe1  of this

  * Landanum fliould always be tried by the mouth in large dofes, as
it can  be given without delay ;  which is of the utmoft confequencc ;n '
fo dangerous a difeafe.       (I. C.)      •
  t The patient  may go into the warm bath,  which  is more  effic«r-
cious.        (I. C.
i ■ ■ -.. 
SWOONINGS.                   305
difeafe ; for which reafon, thofe who are afflicted with it, ought to
avoid all flatulent food.  Deep thought,  anxiety, or any thing diat
oppreffes the mind, ought to be avoided.
   As perfons afflicted with the night-mare generally moan, or make
fome noiSe in die fit, they fhould be waked, or Spoken to by Such as
hear them, as the uneafineSs generally goes off as Soon as the patient
is awake.  Dr. Whytt fays, he generally found  a  dram oS brandy,
taken at bed-time, prevent this diSeaSe.  That, however, is a bad
cuftom, and  in time loSes its effect.   The patient fhould rather de-
pend upon the  ufe of food  of eafy digeftion,  cheerfulnefs, exercife
through the  day, and a light fupper taken early, than accuftom him-
felf to drams.  A glafs of peppermint-water will often promote di-
geftion as much as a glaSs of brandy, and is much Safer. After a per-
fcn of  weak digeftion,  however, has eaten flatulent food, a dram
«nay be neceffary ;  in this cafe, it is the moft proper medicine.-
                       Of Swoonings.

  PEOPLE of weak nerves or delicate conftitutions, are liable td
fwoonings or fainting fits. Thefe are feldom dangerous when duly
attended to; but when wholly neglected, or improperly treated,
they often prove hurtful, and fometimes fatal.
  The general caufes of fwoonings are, fudden tranfiticn from cold
to heat; breathing air that is deprived of its proper  fpring or elaf-
ticity; great Satigue ; exceffive weakneSs ; loSs oS blood ;  long-
fafting ;  fear, grief, and other violent paffions or affections of the
mind.
  Perfons who have been long expofed to  cold, often faint cr fall
into a Swoon, upon  coming into the houSe,  eSpecially iS they drink
hot liquor, or fit near a'large fire.  This might eafily be  prevented
by people taking care not to go into a warm room immediately af-
ter  they have been expoSed to the cold air, to approach the fire gra-
dually, and not to eat or drink any thing hot, till the body has been
gradually brought into a warm temperature.
  When any one, in conSequence of neglecting thefe precautions,
falls into a fwoon, he ought immediately to be removed to a cooler
apartment, to have  ligatures applied above his  knees and elbows,
and to have his hands and face fprinkled  with vinegar or cold water.
Hv; fhould likewife be made to fmell to vinegar, aud fliould have a
fpoonful or two of water,  if he  can Swallow, with about a third-
part of vinegar mixed with it, poured into his mouth.  If thefe fhould
net remove-the complaint, it will be neceffary to bleed the patient,
and afterwards to give him -a clyfter.                      ^
  As air that is breathed frequently  lofes its elafticity or fpring, it
is no wonder, u perfons who re Spire in it, oSten Sail  into  a lwoon or
fainting fit. Ti^y are,  in this  cafe, deprived of the very principle 
 310                   SW00NINGS.

 of life. Hence it is, that fainting fits are fo frequent in all crowded
 affemblies, efpecially in hot feafons.   Such fits, however, muft  be
 confidered as a kind of temporary death ; and, to the weak and de-
 licate, they fometimes prove fatal.   They ought, with  the  utmoft
 care, to be guarded againft.  The method of doing this is obvious.
 Let affembly-rooms, and all other places of public refort, be large
 and well ventilated; and let the weak and delicate avoid fuch places,
 particularly in warm feafons.
   A perfon  who faints, in  fuch a fituation, ought  immediately to
 be carried into the open air ; his temples  fhould be rubbed with
 ftrong vinegar or brandy, and volatile fpirits or falts held to his nofe.
 He fliould be laid upon his back with his head low, and have a little
 wine, or fome other cordial, as  foon as he is able to Swallow  itj
 poured into his mouth. If the perfon has been fubject to hyfteric fits,
 caftor or afafcetida fhould be applied to the nofe, or burnt feathers,
 horn, or leather, &c.
   When fainting-fits proceed from mere weaknefs or exhauftion,
 which is often the cafe  after great  fatigue,  long fafting, lofs  of
 blood, or the like, the patient muft be fupported with generous cor-
 dials, as jellies, wines, fpirituous liquors, &c. Thefe, however, muft
 be given at firft in very Small quantities, and increaSed gradually as
 the patient is able to bear them.   He  ought to be allowed  to  lie
 quite ftill and eaSy upon his back,  with  his head low,  and fliould
have Srefh air admitted into his chamber.  His Sood fhould confift
 of nourifhing hroths, Sago-gruel with  wine,  new milk,  and other
 things of a light  and cordial nature.   Thefe  thing are to be given
 out oS the fit. All that can be done in  the fit is, to let him Smell to
a bottle of Hungary-water,  eau de luce, or Spirits  of hartfliorn, and
to rub his temples with warm brandy,  or to lay a comprefs dipped
 in it to the pit of the ftomach.
   In fainting-fits that proceed from fear, grief, or  other violent paf-
 fions or affections of the mind, the patient muft be very cautioufly
 managed. He fhould be fuffered to  remain at reft, and only made
to fmell fome vinegar.  After he  is come  to himfelf", he may drink
freely of warm lemonade, or balm-tea,  with Some orange or lemon-
peel in it. It  will likewiSe be proper, if the fainting-fits  have been
long and fevere, to clean the bowels by throwing in  an emollient
clyfter.
   It is common in fainting-fits, from whatever cauSe they proceed,
to bleed the  patient.  This  practice  may  be  very proper in ftrong
perSons oS a Sull habit;  but  in thoSe who are weak and delicate, or
fubject to nervous diforders, it is dangerous.   The proper method
with Such people is, to  expofe them to the free air, and to ufe cor-
dial  and  Itimulating median:*, as volatile  falts, Hungary-water,
Spirits of lavender, tincture of caftor, and the  like. 
3"
                   Of Flatidencies,  or Wind.

   ALL nervous patients, without exception, are afflicted with wind
Qr flatulencies in the ftomach and bowels, which arife chiefly Srom
the want oS tone or vigour in theSe organs.  Crude, flatulent ali-
ment, as green peaSe, beans, coleworts, cabbages, and Such-like, may
increaSe this complaint; but ftrong and healthy people are Seldom
troubled with wind, unleSs they either  overload their ftomachs, or
drink  liquors that are in a Sermenting  ftate, and consequently full
of elaftic air.  While, therefore, the matter of flatulence proceeds
from our aliments, the caufe which makes air feparate from them,
in fuch quantity as to occafion complaints, is almoft always  a fault
of the bowels themfelves,  which are too weak  eidier  to prevent the
production of elaftic air, or to expel it after it is produced.
   To relieve this complaint, fuch  medicines ought to be ufed as
have a tendency to expel wind, and by Strengthening the alimen-
tary canal, to prevent its being produced there*.
   The lift oS medicines Sor expelling wind is very numerous; they
often difappoint the expectations of both the phyfician and his pa-
tient.  The moft celebrated among the  clafs of carminatives are ju-
nipar-berries; the roots of ginger and zedoary ; the  feeds of anife,
caraway, and coriander ; gum afafcetida and opium ;  the warm wa-
ters, tinctures, and fpirits, as the  aromatic water,  the tincture of
woodfoot, the volatile aromatic Spirit, aether, &c.
   Dr. Whytt Says, he found no medicines more efficacious in  ex-
pelling wind than asther and laudanum.  He generally gave the lau-
danum in a mixture with peppermint-water and tincture of caftor,
or fweet fpirits  of* nitre. Sometimes, in place of this, he gave opi-
um in pilk? with afafcetida.  He obferves,  that the good effects of
opiates are equally confpieuous, whether the flatulence be contain-
ed in  the ftomach or inteftines;  whereas, diofe warm medicines.,
commonly called carminatives, do not often give immediate relief,
except when the wind is in the ftomach.
.   With regard  to aether, the Doctor fays, he has often  feen very
good effects from it in flatulent complaints, where other medicines
failed.  The dofe is a  tea-fpoonful mixed with two table-fpoonfuls
of waterf. In gouty cafes, he obferves, that aether, a glafs of French
brandy, or of the aromatic  water, or ginger, either  taken  in fub-

  #■  Many nervmis people find great benefit from eating a dry  bifcuit,
efpecially when the itomach is empty. This is one of the beft carmina-
tive medicines in all complaints of the ltomach, arifing from flatulence,
indigeftion, Sec.

  t Though the patient may begin with this quantity, it  will be necef-
fary to increafe the dofe gradually as the ftomach can be;;r it.   /Ether
is now  given in conlhierab'ly greater doles than it was in Dr. Why:'.''-:
time. 
3t*        FLATULENCIES, OR  WIND.

Stance or infufed in  boiling water, are  among the beft medicine*
for expelling wind.
   When the cafe of flatulent patients  is fuch as makes it impro-
per to give them warm medicines inwardly, he recommends exter-
nal applications, which are fometimes of advantage.   Equal parts
of die anti hyfteric and ftomach plaifter  may be  fpread upon a
piece of foft leather, of fuch fize as to cover the  greater part of
the belly.   This fhould be kept on for a  confiderable time, provi-
ded the patient be able to bear it; if it fhould give  great uneafi-
nefs, it may be" taken off, and the following liniment ufed in its
ftead:
   Take of Bates's  anodyne  balfam an ounce; of the expreffed  oil
of mace half an ounce ; oil of mint  two drachms.  Let  thefe  be
mixed together, and  about  a table-fpoonful well  rubbed on  the
parts at bed-time.
   For ftrengthening the  Stomach and bowels, and  leffening the
production of flatulence, the  Doctor recommends the  Peruvian
bark, bitters, chalybeates, and exercife. In flatulent cafes, he thinks
fome nutmeg or ginger fhould be added to the tincture of the bark
and bitters, and that  the aromatic powder fhould  be  joined  with
the filings of iron.
   When windy complaints are attended with coftiveneSs, which
is often the cafe, few things will be found  to  anfwer better than
four or five of the following pills taken every night at bed-time.
   Take of afaScetida, two drachms ; Succotrine aloes,  Salt of iron,
and powdered ginger, of each one drachm ; as much  of the elixir
proprietatis as will be fufficient to form them into pills.
   On the other hand, when the body is too  open, twelve or fifteen
grains of rhubarb, with half a drachm, or two feruples of the Japo-
nic confection, given every other evening, will have very good  ef-
feas.
   In thofe flatulent complaints which come on about the time the
menfes ceafe, repeated  Small bleedings often give more relief than
any other remedy.
   With regard to diet, the Doctor obferves, that  tea, and all flatu-
lent aliments, are to be avoided; and that for drink, water widi a
little brandy or  rum is preferable to malt liquor, and in moft cafes
to wine.
   Dr.  Whytt has paid great  attention to this fubject;  his fenti-
ments upon it, in a great meaSure, agree with mine. I fhall only add
to his obfervation,  that exercife is, in my opinion, Superior to all
medicin?,  both  Sor preventing the production and likewiSe for ex-
pelling of flatulencies.  Thefe effects  are not to be expected from
faultering about, or lolling  in a carriage ; but from labour, or fuch
active amufements as give exercife to every part of the bedy. 
C   3'j   3
                       Of Low Spirits.

   ALL who have weak'nervcs are fubject to low fpirits in a grea&
 ter or lefs  degree. Generous diet,  the cold  bath,  exercife,  and
 amufements are the moft likely means to remove this complaint. It
 i.-,- greatly  increafed by folitude  and indulging gloomy ideas ; but
 may  often be relieved by cheerful company and fprightly amufe*
 ments.
   When low fpirits are owing to a weak relaxed ftate of the fto-
 mach and bowels, an infufion oS the bark with cinnamon or nut-
 meg  will be proper. Steel joined with aromatics may be uSed with
 advantage; but riding,and a proper diet, are moft to be depended on.
   When they ariSe from a fculnefs of the ftomach and inteftines,
 or obstruction in the hypochondriac viScera, aloetic  purges will be
 proper.  I have known the Harrowgate Sulphur-water of fervice in
 this cafe.
   When lowv fpirits proceed from a fuppreffion of the menftrual or
 of the haemorrhoidal flux, thefe evacuations may either be  reftored,
 or fome odicrs fubftituted in their place, as iffues,  fetons,  or the
 like.  Dr. Whytt obferves, that nothing has fuch fudden good effects
 in this cafe as bleeding, if the ftrength of the patient will  admit of
 it.
   When low fpirits have been brought on by long cdntinued grief,
 anxiety, or other diftrefs  of mind', agreeable company, variety of
. amufements, and change of place, efpecially'travelling into foreign
 countries, will afford the moft certain relief.
   Perfons afflicted with low fpirits fliould avoid all kinds of excefs,
 efpecially of venery and ftrong liquors. The moderate  ufe of wine
 and other ftrong liquors is by no means hurtful j but when taken td
 excefs, die'y weaken the ftomach, and deprefs the fpirits. This cau-
 tion is the more neceffary, as the unfortunate and melancholy often
 fly to ftrong liquors for relief, by which means they never fail ttf
 precipitate their own destruction.
                    Of Hyfteric Affeclions.

  THESE likewiSe belong to the numerous tribe, of nervous difea-
fes, which may be juftly reckoned the reproach oS  medicine. Wo»
men of a delicate habit, whofe ftomach and inteftines are relaxed,
and whofe  nervous fyftem is extremely fenfible, are moft Subject to
hyfteric complaints. In Such perSons, an hyfteric fit, as it is called,
may be brought on by an irritation of the nerves of the ftomach or
inteftines, by wind, acrid humour, or the like.   A fudden fuppref-
fion oithemenfes often gives rife to hyfteric fits. They may likewise
                             R z 
314           HYSTERIC AFFECTIONS.

be excited by violent paffions or affections of the mind, as fear,
grief, anger, or great disappointments.
  Sometimes the hyfteric fits reSemble a Swoon or feinting fit, du-
ring which the patient lies as in a fleep, only the breathing is So low
as fcarce to be perceived.  At other times the patient is affected,
with catchings. and ftrong convulfions. The Symptoms which pre-
cede hyfteric fits are.likewiSe various in different perSons.  Some-
times the fits come on with  coldneSs oS the extremities, yawning
and Stretching, lowneSs oS Spirits, oppreffion and anxiety.  At other
times the approach  oS the fit is  foretold by a Seeling, as if there
were  a  ball at the lower part oS the belly, which gradually riSes
towards  the ftomach, where it occafions inflation,  ficknefs,  and
fometimes vomiting ; aSterwards it riSesinto the gullet,  and occa-
fions a degree of .fuflbcation,  to which quick breathing, palpitation
OS the heart, giddinefs cf the head, dimnefs of the fight, lofs of hear-
ing, with convulfive motions of the  extremides and other parts of
the body, fucceed.  The hyfteric paroxyfm is  often introduced by
an immoderate  fit of laughter, and fometimes it goes off by crying.
Indeed,  there, is not much difference between the laughing and cry-
ing of an highly hyfteric lady.
  Our aim in the. .treatment  of this difeafe muft be to fhorten the
fit or  paroxyfm when prefent, and to prevent its return,   fhe lon-
ger the  fits continue, and the more frequently  they return, the dif-
eafe becomes the more obftinate. Their ftrength is increafed by ha-
bit, and  they induce fo great a relaxation of  the fyftem, that it is
with difficulty removed.
  It is cuftomary, during  the hyfteric fit or paroxyfm, to bleed the
patient. In ftrong perfons of a plethoric habit, and where the pulfe
is full, this may be proper ; but in weak and delicate conftitutions,
or where the difeafe has been of long Standing, or ariSes Srom  ina-
nition,  it is not Safe. The beft courfe in fuch caSes is to rouSe the
patient by ftrong Smells, as burnt feathers, afafcetida, or  fpirits of
hartfliorn, held to the nofe. Hot bricks may be applied to the foles
of the feet, and the legs, arms, and belly may be ftrongly rubbed
with a warm cloth.  But the  beft  application is to put the feet and
legs into warm  water.  This is peculiarly proper when the fits pre-
cede the flow of the menfes.  In cafe of coftivenefs, a laxative clyf-
ter  with afafcetida will be proper;  and as foon as the patient can
fwallow, two  table-fpoonfuls of a folution of  afafcetida  may be
given*.
  The radical cure of this diforder will be beft attempted at a time
when the patient is moft free from the  fits. It will be greatly pro-

  ■fc- When hyfteric fits are occafioned by fympathy, they may be cured
by exciting an oppohte paflion. This is (aid to have been the  cafe of a
whole fchool of young ladies in Holland, who were all cured by being
told, that the firft who was feized fhould be burnt  to death. But this
method of cure, to my knowledge, will not always fucceed.  I  would
therefore advife,that young ladies who  are fubjed to hyfteric fits, fliould
not be fer.t to boarding fchools. as the difeafe may be caught by imita-
 ioii. I have known madnefs itfelf brought on by fympathy. 
HYSTERIC AFFECTIONS,           314
wioted by  a proper attention to diet. A milk and vegetable diet
when duly perfifted in, will often perform a cure. If however the
patient has been accuftomed to a more generous diet, it will not be
fafe to leave it off all at  once, but by degrees. The moft proper
drink is water, with a fmall quantity of fpirits.  A cool dry air is the
beft.  Cold bathing and every thing that braces the nerves, and in-
vigorates the fyftem, is beneficial; but  lying too long  in bed, or
whatever relaxes  the body, is hurtful. It is of the greateft impor-
tance to have the mind kept conftantly eafy and  cheerful, and, if
poffible, to have it always engaged in fome agreeable and interes-
ting purfuit.
  The proper medicines  are thofe which Strengthen the alimentary
canal and the whole  nervous Syftem, as the preparations of iron, die
Peruvian bark, and other bitters. Twenty drops of the elixir of vi-
triol, in a cup of  the  infufion of the bark, may be taken twice or
thrice a-day.  The bark and  iron may likewife be taken in fub-
ftance, provided the ftomach can bear them ; but they are generally
given in too fmall dofes to have any effea.  The  chalybeate waters
generally prove beneficial in diis diforder.
  If the ftomach is loaded with phlegm,  vomits will be of  ufe ;
but they fhould not be too ftrong, nor frequently repeated, as they
tend to relax and weaken the  ftomach.  If there  be a tendency to
coftivenefs, it  muft be  removed either  by diet, or by taking an
opening pill as often as it fhall be found necefiary.
  To leffen the irritability of the fyftem, antifpafmodic medicines
will be of ufe. The beft  antifpafmodic medicines are mufk, opium,
aud caftor. When opium difagrees with the ftomach, it may either
be applied  externally, or  given in clyfters.  It is often fuccefsful in
removing  thofe periodical head-achs'to which hyfteric and hypo-
chondriac patients are fubject.  Caftor has in fome cafes been found
to procure fleep where opium failed;  for which reafon, Dr. Whytt
advifes, that they fhould  be joined together. He likewife  recom-
mends the  antihyfteric plaifter  to be applied to the abdomen*.
  Hyfteric women are oSten afflicted with cramps m various parts
of the body, which  are  moft  apt to feize  them ;.i bed, or when
afleep The moft efficacious medicines in this cafe axe opium, put-
ters, and warm bathing or fomentations.  When the cramp ot tpafrn
is very violent, opium is the medicine moft  to be depended on.  In
milder cafes/ immerfing the feet and  legs in warrn water, or apply-
ing a blifter to the part affeaed, will ofteh be fufficient to remove
the  complaint. In patients whofe nerves are uncommonly delicate
and fenfible, it will be better to omit the blifter, and to attempt the
cure by opiates, mufk, camphire, and the warm bath.
  Cranms  are  oSten prevented or  cured  by compreffion.   ihus
cramps hi the legs are prevented, and fometimes  removed, by tight

  *  ThotiKh antifpafmodics and anodynes are universally recommended
in this d feafe, yet all the extraordinary cures that I ever knew in hyf-
tedc cafesfwere performed by means of tonic and corroborating medi-
cines. 
315      HYPOCHONDRIAC  AFFECTIONS.

bandages ; and when convulfions arife from a flatulent distention
of the inteftines, or from fpafms beginning in them, they may be,
often leffened or cured by  making a pretty ftrong compreffion up-
on the abdomen by means of a bread belt.  A roll of  brimftone
held in the hand is frequently ufed as a remedy for cramps. Though
this feems to owe its effe& chiefly to imagination ; yet, as it fome-
times fucceeds, it merits a trial*.  When fpafms or convulfive mo-
tions ariSe from fharp humours in the ftomach  and inteftines, no
lafting relief can be procured till thefe are either corre&ed or ex-
pelled. The Peruvian bark ha9 fometimes cured periodic convulSiom
after other medicines had failed.




                Of Hypochondriac  Affeclims.

   THIS diSeaSe generally  attacks the indolent, the luxurious, the
unSortunate, and the ftudious.  It becomes daily more common  in
this country, owing, no doubt, to the increafe of luxury and feden- ,
tary employments. It has fo near a refemblancc to the immediate-
ly preceding, that many authors confider them  as the fame difeafe,
and treat them accordingly. They require however a very different
regimen ; and the fymptoms of the latter, though lefs violent, are
more permanent than thofe of the former.
   Men of a melancholy temperament, whofe minds are capable  of
great attention, and whofe paffions are not eafily moved, are, in the
advanced  periods of life, moft liable to this difeafe.  It is ufuatly
brought on by long and ferious attention to abftrufe fubjeas, grief,
the fuppreffion of cuftomary evacuations, excefs  of venery, the re-
pulfion of cutaneous eruptions, long-continued evacuations, obftruc-
iions in Some of the viScera, as the liver, fpleen, &c.
   Hypochondriac perfons ought never to  faft long, and  their food
fliould be folid and nourifhing.   All acefeent and windy vegetables
are to be avoided.  Flefh meats agree beft with them, and their drink
fhould be old claret, or good Madeira.  Should diefe difagree with
the ftomach, water with a little brandy or  rum in it may be drank.
   Cheerfulnefs and ferenity of  mind are  by all means to be culti-
vated.  Exercife of every kind is ufeful.  The cold bath is likewife
beneficial; and, where it does not agree with the patient, fri&ions
with the flefh-brufhor a coarfe cloth may  be tried.  If the patient
has it in his power, he ought to travel either by fea or land. A voyage
or a long journey, efpecially  towards a warmer climate, will  be
of more fervice than any medicine.

  ■Jf  Some perfons afflicted with cramps pretend to reap great benefit
from fmall bundles of rofemary tied all night about their Seet, ancles,
and knees. 
          HYPOCHONDRIAC  AFFECTIONS.    317

  The general" intentions of cure, in this difeafe, are to Strengthen
the alimentary canal, and to promote the Secretions.   TheSe inten-
tions will  be beft anSwered by the different preparations of iron and
the bark, which, after proper evacuations, may be taken as direaed
in the preceding difeafe.
  If the patient be coftive,  it will be neceffary to make ufe of fome
gentle opening medicine, as pills compofed of equal parts of aloes,
rhubarb, and afafcetida, with as much  of the elixir  proprietatis' as is
neceffary to form the ingredients into pills.   Two, three,  or four,
of thefe may b» taken as often as it fhall be found needful, to keep
the body gently open. Such as cannot bear the afafcedda may fub-
ftitute Spanifh foap in its place.                              •  '
   A  cheerful glafs may have good effeas  in  this difeafe, but all
manner of excefs is hurtful. Intenfe ftudy, and every thing that de-
prefles the fpirits, are likewife pernicious.
   Though the general fymptoms and treatment of  nervous difor-
ders were pointed out in the beginning of this chapter ;  yet, for the.
benefit of  the unhappy perfons afiliaed with thefe  obftinate and
complicated maladies, I have treated feveral of  their  capital fymp-
toms under diftina or feparate heads.  Thefe are not to be confider-
ed as different difeafes, but as  various modifications of the  fame
difeafe.   They all arife from  the fame general caufes,  and require
nearly the fame method of treatment.  There  are many other fymp-
toms that merit particular  attention, which the  nature of my  plan
will not permit me to treat  of at full length. I therefore omit them,
and conclude this chapter with a few  remarks on the means of pre-
venting or'avoiding nervous diforders.
   In all perfons thus afflicted, there is  a great delicacy and fenfi-
bility of the whole nervous fyftem, and an uncommon degree of weak-
nefs of the organs of digeftion.  Thefe maybe either  natural or ac-
quired. When owing to a defea in the constitution, they are hardly
to  be removed ; but  may be mitigated by proper care. When in-
duced by diSeaSes, as long or repeated  Severs, profufe.  haemorrhages,
pr the like, they prove alfo very obftinate, and  will  yield only to a
courfe of regimen calculated to reftore and invigorate the habit.
   But nervous affeaions arife more frequently  from caufes, which
it is,  in a great meafure, in our power to avoid, than from difeafes,
or a.i original fault in the conftitution, &e. Exceffive grief, intenfe
ftudy, improper diet, and  neglea of exercife, are  the great fources
of this extenfive claSs of difeafes.
   Grief indulged, deftroys the appetite and digeftion, depreffes the
Spirits, and induces an univerSal relaxation and debility of the whole
Syftem.   Inftances of this  are daily to be feen.  The lofs of a near
relation,  or any other misSortune in  life, often occafions the moft
complicated Series in nervous Symptoms. Such  misSortunes are net
to  be avoided, but their effeas, by a vigorous and proper exertion
of  the mind,  might be rendered lefs hurtful.  We refer the reader to
the article Grief, in the chapter on the paffions. 
318        DISORDERS OF THE SENSES.

   The effeas of intenfe ftudy are pretty fimilar to thofe occafioned
by grief.  It preys upon the animal fpirits, and deftroys the appetite
and digeftion. To prevent thefe effects, ftudious perfons ought, ac-
cording to the poet, to toy with their books*. They fhould never ftudy
too long at a time;  nor attend long to one particular fubjea, es-
pecially if it be of a Serious nature. They ought likewiSe to be at-
tentive to their pofture, and take  care frequently  to unbend their
minds by mufic, diverfions, or going into agreeable company.
  With regard to diet, nervous difeafes may be induced either by
excefs  or  inanition.  Both of thefe extremes hurt  the digeftion.
When Nature is oppreffed with frefh loads of food,  before fhe has
had time to digeft and aflimilate the former meal, her powers are
weakened.   On  the  other  hand, when the food is not fufficiently
nourifhing, or is taken  too feldom, the bowels  are inflated with
wind.  Thefe extremes  are with equal care to be avoided.   They
both tend to induce a relaxation,  and debility of  the nervous fyf-
tem, with all  its confequences.
  The moft general caufe of nervous diforders is indolence.   The
aaive and laborious are feldom troubled with them.  They are re-
ferved for the children of eafe and affluence, who generally feel their
keeneft force. The means of prevention and cure are both in their
power. If the conftitution of human nature be fuch, that man muft
either labour  or fuffer difeafes, no individual has a right to expea
exemption from the general rule.
  Thofe who are willing to take exercife, but whofe  occupations
confine them  to the houSe, and perhaps to an unSavourable pofture,
deServe pity.
  We  have," in  the Sormer part oS this book, endeavoured to lay
down rules Sor their condua ; and where theSe cannot be complied
with, their place may, in Some meaSure, be  Supplied by the uSe of
bracing and Strengthening medicines, as the bark,  with odier bit-
ters ; the preparations of fteel; the elixir of vitriol, &c.
               CHAPTER    XLVI.

                   Difrders of the Senfes.

"W TE  do not mean to give a defcription oS the organs by which
 Yy   the SenSes are performed; but to point out fome of the
difeafes to which thefe organs are moft liable, and to fliew how they
may be prevented or remedied.                v
• Anr.ftrong on health. 
[   3*9   3
                         Of the Eye,

  NO organ of the body is fubjea to more difeafes than the eye j
rior is there any one of which the difeafes are more difficult to cure.
Though more ignorant perfons pretend to cure thefe than any other
claSs  of  difeafes ; yet a very  fuperficial acquaintance with  the
ftruaure of the eye, and the nature of vifion, will  be fufficient to
convince any one of the danger  of trufting to  them.  TheSe diSeaSes*
often exceed the fkill of the  moft learned phyfician ;  hence we may1
inSer the danger of "tfufting them to  ignorant quacks, who put  out
more eyes than they cure.  But, though the difeafe^ of the eye can
feldom be cured, they might often, by due care, be prevented ; and,
even  where the fight  is totally loft, many .things might? be done;
which are generally negfeaed, to render the perfon  both mere ufe-
ful  to himfelf and to fociety*.
  The eyes are hurt by viewing bright or luminous objeas; keep-
ing the head too long in  a hanging pofture ; violent head-achs ^ex-
ceffive venery; the long ufe of bitters ;  the effluvia from acrid or
volatile fubftances;  various difeafes ; as the1 fmall-pox, meafles, Sic.
but, above all, from night-watching, and candle-light ftudies. Long
fafting is likewife hurtful to the eyes, and frequent heats and colds
are  no lefs pernicious.   The eyes are often hurt by the ftoppage of
cuftomary evacuations ; as  morning fweats ;  fweating of the feet;
the menfes in  women ;  and the bleeding piles in men.  All kinds
of excefs are hurtful to the  fight, particularly the immoderate ufe of
ardent fpirits and other Strong liquors.
  In all diSeaSes oS the eyes, eSpecially thoSe attended with inflam-
mation, the  cool regimen ought to be obServed. The patient muft
abftain from.all fpirituous  liquors. The fmoke of tobacco, fmoky
rooms, the  vapours of onions and garlic, and all vivid lights  and
glaring colours, ate carefully to be avoided. The drink may be wa- t
ter, whey, or fmall beer; and the aliment muft he light and of ea-
fy digeftion.
  For preventing diforders  of the ey«s, iffues and  fetons are of
prime ufe.  Every perSon, whoSe eyes are tender, ought to have one
or more of thefe in fome part of the body. It will likewife be of ufe
to keep the  body gently open,  and either to bleed or purge every

  •  It is pity thofe who have the  misfortune to be born blind, or  who
lofe then- light when young,  fhould be fuffered to remain in ignorance,
or to beg. This is both cruelty and want of economy. There areniaTiy
employments of which blind  perfons are very capable, as knitting,card-
ing, turning a wheel, teaching  Janguages, &c. . Js'or are inftafiees want-
ing of perfons who have arrived at the higheft pitch of learning, with-
out  having the leaft idea of light.  Witnefs the  late famous .Nicholas
Sanderfon of Cambridge, and Dr. Thomas Blacklock  of Edinburgh.
The former was one of the firft mathematicians  of his age, and the Ut-
ter  befides being a good poet  a:id  philofopher,  is matter of all the
fearned hiatus ^s, and a very cunfideyable adept in the liberal arts. 
  320                  OF THE EYE.

  fpxing aud fall. All excefs and night ftudies are to be avoided.. Such
  as do not choofe a feton  or an iflue, will find benefit from waging a
  fmall Burgundy-pitch plafter between their flioulders.
  , -A gutta ferena, pr amaurofs, is axi  abolition oS the fight  will.out
  any apparent cauSe qr fault in the eyes. When it is owing to a decay
  qr waiting oS the opdc nerve, it does not admit of a cue; but when
  Lt  proceeds from a compreffion of the nerves by redundant humours,
  thefe may in .fame  meafure  be drained off, and the patient reliev-
  ed.  For this purpofe, the body muft be kept open with the laxative
  mercurial pills. If the patient be young and or a Sanguine habit,  he
  maybe bled.  Cupping,  with fearifications oh  the back part of the
 "head, will likewife  be of ufe.  A rumaing £t the nofe may be pro-
  moted by voladle Salts,. Stimulating powders, Sec. But the moft like-
  ly means for relieving the patient, are iffues or blifters kept open for
. a long time on the back part  of the head, behind the ears, or on the
  neck. I have  known thefe reftore fight, even after it had been for a
 confiderable time loft.  Should thefe fail, recourfe muft be had to a
  mercurial falivation*.
  ,  A cataracl is an obftruaion of the pupil, by the  interpefition  of
  fome opaque fubftance, which either diminishes or totally extin-
  guishes the fight.  It is. generally an opacity of the chryftalline hu-
  mour.  In a recent or beginning cataraa, the Same medicines are  to
  be ufed as in the gutta  ferena  ; and  they wilt fometimes fucceed.
  But when this^does  not  happen,  and the cataraa becomes firm, it
  muft be couched, or rather extracted. I  have refolved a recent ca-
  taraa by giving the patient frequent purges with calomel,  keeping
  a poultice oS Srefh hemlock conftantly upon the eye, and a perpetu-
  al  bfifteron the neck.
    The.myopia, or Jliortfightcdnefs, and the prefbyopia, ox feeing only at
 too great a diftance, ,are, diforders which depend on the original Struc-
  ture or figure of the eye, therefore admit of no cure. The inconve-
 jiiencips'arifing, from them, may however be.,  in fome meafure, re-
 medied,by the help  of proper glafles.  The,former  requires the aid  ,-
  of a concave, and the latter of a convex glafs.
    Aflrabifmus or fquinting,  depends  upon an irregular contraaicm
  of the  mufcles of the eye from.a fpafm, palfy, epilepfy, or an ill ha--
  bit.  Children often  contraa  this diforder by having their eyes un-
 equally expofed to the light. They may likewife acquire it by imi-
  tation from a fquinting  nurfe or play fellow, &C.   As this  diforder
 (tan hardly be cured, parents  ought to be careful to prevent it.  Al-
 moft the  only thing which can be done for it, is to contrive a mafk
 for the child  to wear, which will only permit him to fee in a ftraight
  direaionl
    Spots orfpecks on the eyes are generally the effea of inflammation,
 and often appear after the fmall-pox, the meafles, or violent ophthal-

   * Elefluary has been known to have a good effect in this difeafe, par-
 ticularly arhsn applied to parts near the eyes,          ('.. C*) 
                          THE  EAR.                   321

tfiias. They are very difficult to cure, and often occafion total blind-
nefs.  If the fpecks are foft  and thin, they may fometimes be taken
off by gentle cauftics and difcutients; as  vitriol, the juice of celan-
dine, &c.   When thefe do not fucceed, a furgical operation may
be tried : the fuccefs of which is always very doubtful.
   The blood-fhot eye may be occafioned by a Stroke," a fall, retching,
vomiting, violent coughing, &c. I have frequently known it happen
to children in the hooping-cough.  It appears at firft like a bit of
fcarlet, and is afterwards of a livid  or blackifh colour.   This disor-
der generally goes tfff without medicine.  Should it prove obftinate,
the patient  may be bled, and have his eyes bathed with rich led wa- >
ter, and the body fhould be kept open by gentle purgatives.
   The watery or weeping eye is generally occafioned by a relaxation
of weaknefs of the glandular  parts of that organ.  Thefe may be
braced and Strengthened by bathing the  eye with brandy and wa-
ter,  Hungary-water, rofe-water with  white vitriol diffolved in it,
&c.  Medicines which make arevulfion are likewife proper; as mild
purgatives, perpetual blifters on the neck, bathing the feet frequent-
ly in lukewarm water, &c.
  When this difeafe proceeds from  an obftruaion of the lachrymal
duct, or natural paffage of the tears, it is called a fiftula lachryma-
ls, and can only be cured by a Surgical  operation;
                        Of the  Ear.

  THETunaions of the ear may be injured by wounds, ulcers, 6r
any thing that hurts its fabric.  The hearing may likewife  be hurt
by exceffive noife;  violent colds in the head ; fevers, hard wax, or
other fubftances fticking in the cavity of the ear; too great a degree
of moifture or drynefs of the ear.  Deafnefs is very often the effea
of old age,  and is incident to moft people in the decline of life;
Sometimes it is owing to an original fault in the ftruaure or for-
mation of the ear itfelf.   When this is  the cafe, it admits of no
cure; and the perfon not only continues deaf, but generally likewife
dumb for life*.
  When deafnefs is the effea of wounds or ulcers of the ears, or
of old age, it is not eafily  removed. When it proceeds from cold

  #•  Though thofe born deaf are generally  fufFered to continue dumb,
andconfequently are, in a great meafure, loft to fociety, yet nothing is
more certain than that fuch perfons may be  taught not only to read and
Write, but alfo to fpeak, and to understand what others fay to them.
Teaching the dumb to fpeak will  appsar paradoxical to thofe  \fho dd
not confider that the  formation  of founds is merely mechanical, and
may be taught without the affiftance of the  ear. This, is not only capa-
                             S a 
322
THE EAR.
of the head, the patient muft be careful to keep his head warni, es-
pecially in the  night; he fhould likewife take fome gentle purges,
and keep his  feet  warm, and bathe them  frequently in lukewarm
water at bed-time.  When deafnefs is the effea of a fever, it gene-
rally  goes off after the patient recovers. If it proceeds from dry
wax  fticking  in the ears, it may be  foftencd by dropping oil into
them* ; afterwards they muft be  fyringed  with warm milk and
water.
   If  deafnefs  proceeds from  drynefs  of the ears,  which may be
known by looking into them,  half an ounce ot the  oil of fweet. al-
monds, and the fame quantity of liquid apod'eldoch, or tinaure of
afafcetida, may be mixed together, and a few drops.of it put into
.the ear every night at bed-time, itopping them afterwards with a
little wool or cotton.  Some, inftead of oil, put a fmall flice of the
fat of bacon into each ear,, which is faid to juifwer the  purpoSe ve-
jry well. When the ears abound with moifture,  it may qe drained
oft'by an iffue  or Seton, which, fhould be made as near the affeaed
, parts as poffible.
   Some, Sor the  cure of  deafnefs,  recommend the gall of an eel
mixed  w ith fpirit of wine,  to be dropped into the ear; others,
equal parts of Hungary-water and fpirit of lavender.  Etmuller ex-
 tols  amber and mufic ; and Brcokes fays, he  has often known hard-
 nefs  of hearing cured, by putting a grain or two of mufk into the
 car with cotton-wool. But theSe and other applications muft be va-
ried, according to the cauSe oS the diSorder.
   Though Such applications may  Sometimes be of Service, yet they
much oftener fail, and frequently they do hurt. Neither the eyes nor

ble of deiypnnration,  but is actually reduced' to;pra£Hce by Mr. Thomas
Bia;dwo«drjui* Edinburgh.  This gentleman has, by the mere force of
 genius  and application, brought the teaching of dumb perfons to fiicha
 degree of perfection,  that his fcholars ate generally more forward in
 their education than tl:pfe of the fame age who enjoy all their faculties.
 They not only read and write v.ith the utnioft readinefs, but likewife
 fpeak,  and are capable of hftlding converfation with any perfon in the
 light. What a pity any of the human fpecie's fiiould remain in a ftate of idi-
 ofifm  who are capable of being  rendered  ufeful  and intelligent.
 We  mention this not  only from humanity to thofe who have the misfor-
 tune to be born deaf, bur alfo-in juftice to  Mr. Braidwood, whofe fuc-
 cefs  has far exceeded  all former attempts this  way ; and indeed it ex-
 ceeds imagination itfelf fix far, that no perfon who has not feen and ex-
 amined his pupils, can believe What they are capable of.  As this gentle-
 man, however willing, is only able  to teach a lew, and as the far great-
 er part of thofe who are born deaf cannot afford to attend him, it would
 be an  act of great humanity,  as well as of public utility, to ereft an
 academy for their benefit.

   •* GoodefFe&s have been derived from wearing a conical plug in rhe
 ear,  ma'deof the ftalk of a green cabbage, which will, after awhile, give
 out its water, and be  more conftantly applied indiffolving the wax, fa a?
 to prepare it for fvringing with milk and: water,          (I,. C.}
/ 
TASTE  AND SMELL.
3*5
ears ought to be tampered with ;  they  are tender organs, and re-
quire a very delicate touch. I chiefly recommend in deafnefs to keep
the head warm.  From whatever caufe the diforder proceeds this is
always proper; and I have known more benefit from it alone, in
the moft obftinate cafes of deafnefs, than from all the medicines I
•ever ufed.  ,
                      The Tcfle and Smell

   ARE not of fo great importance to man  in a ftate of fociety, as
 •the fight and hearing ; yet, as the lofs of them is attended with in-
 conveniency, they deferve our notice.  They  are feldom to be re-
 ftored when loft ; which ought  to make us very attentive to  their
 prefervation, by carefully avoiding whatever may injure them.   As
 there is a very great affinity between the organs of taftirfg and Smel-
 ling, whatever hurts the one generally affeas the other.
  - Luxury is highly injurious to thefe organs.  When the nofe and
 palate are  frequently ftimulated  by  fragrant and poignant difhes,
 they foon  loSe the power oS  diftinguifhing  taftes and odours  with
 any degree oS nicety. Man, in a  ftate cS nature, may perhaps have
 thefe Saculties as  acute as any .other animal.
   The SenSe oS Smelling may be diminifhed or deftroyed by diSeafe;
 as, the moifture, dryneSs, inflammation or Suppuration oS that memr
 brane which lies  the infide of the nofe, commonly called the olSac-
 tory membrane ;  the compreffion of the nerves which fupply this
 membrane, or fome fait in the brain itfelf" at their origin.  A defea,
 or too great a degree of Solidity,  of the fmall  fpungy bones of the
 upper jaw, the caverns of the forehead, -Sec. may impair the  fenfe
 of Smelling.  It may be injured by a colfeaion of foetid matter in
 diofe  caverns, which keeps conftantly exhaling from them.  Few
 things are  more hurtful, to the fenfe  of fmefling than quantities of
 feuff.
   When the nofe abounds with moifture, after gentle evacuations,
 fuch things as tend to take off irritation, and coagulate the thin, fharp
 Serum, may be applied ; as the oil of anife mixed with fine flour ;
 camphire diffolved in oil of almonds, Sec.  The vapours of amber,
. frankincenfe, gum-maftic, and benjamin, may likewife be received
 Into the nofe and mouth.
   For moiftening the mucus when it is  too dry, Some recommend
 Snuff made of the leaves cf marjoram, mixed with the oil of amber,
 marjoram and anifeed ; or a Sternutatory of calcined white vitriol j
 ..twelve grains of whicli may be mixed with two ounces of marjoram-
 <water, and filtrated.   The fteam  or vapour cS vinegar upon hot iron 
324
THE TOUCH.
received up the noftrils, is of ufe for Softening the mucus, opening
obftruaions, &c.
  If there is an ulcer in the nofe,  it ought to be dreffed with Some
emollient ointment, to which, if the pain be very great, a little lau-
danum may be added. If a venereal ulcer, it is not to be cured with-
out mercury. In that caSe, the Solution oS the corrofive Sublimate in
brandy, may be taken,  as direaed in the  gutta Serena.  The ulcer
ought likewiSe to be wafhed with it; and  the  fumes  of  cinnabar
may be received up the noftrils.
   If there be reafon to fuSpea that the nerves which Supply the or-
gans oS Smelling, are inert, or want Stimulating, volatile Salts, ftrong
fnuffs, and other things which occafion fneezing, may be applied to
the nofe. The forehead may likewife be  anointed with balfam of
Peru, to which may be added a little of the oil of amber.
   The tafte may be diminifhed by crufts, filth,  mucus,  aphthae,,
pellicles, warts, &c. covering the tongue:  it maybe depraved by a
fault of the faliva, which, being difcharged into  the mouth, gives
the fame fenfation, as if the food, which the perfon takes, had real-
ly a bad tafte;  or it may  be  entirely deftroyed*by injuries done to
the nerves of the tongue and palate.  Few things prove more hurt-
ful either to the fenfe of tafting or fmelling than obftinate colds, ef-
pecially thofe which affea the head.
   When the tafte is diminifhed by filth, mucus,  &c. the tongue
ought to be fcraped and frequently wafhed with a mixture of water,
vinegar, and honey, or fome other detergent.   When the  faliva is
vitiated, which feldom  happens unlefs in fevers or other difeafes,
the curing of the diforder is the cure of this fymptom.  To leave it
in the mean time, if there be a bitter tafte, it may be taken away by
vomits, purges, and other things which evacuate bile. What is cal-
led  a nidorous  tafte, arifing  from putrid humours, is  correaed by
the juice of citrons, oranges,  and other acids. A fait tafte is cured by
 plentiful dilution with watery liquors.  An acid tafte is deftroyed by
 abforbents, and alkaline falts,  as  powder of oyfter-fhells, fait of
 worm-wood, &c.
   When the  fenfibifity of the nerves which fupply the organs of
tafte is diminifhed, the chewing of horfe-radifh, or other ftimulatuig,
jubilances, wilj help to recover it.
                          Of the Touch.

  THE fenfe of touching may be hurt by any thing that obftfua%
the nervous  influence, or prevents its being regularly conveyed to
the organs of touching;  as preffure, extreme cold, &c. It may like-
wiSe be hurt by too great a degree of fenfibifity, when the nerve is.
jiot fufficiently covered by the cuticle or fcarf-flrin, or where there 
SCHIRRUS AND CANCER.
is too great a tenfion of it, or it is too delicate. Whatever diforders
the funaions of the brain and nerves, hurts the fenfe of touching.
Hence it appears to proceed from the fame general caufes as palfy-
and apoplexy, and requires nearly the fame method of treatment.
   In zflupor, or defea of touching,  which arifes from  an  obstruc-
tion of the cutaneous nerves, the patient muft firft be purged ;  afte-
wards fuch medicines as excite the  aaion of the nerves, or ftimu-
late the fyftem, may be ufed. For this purpofe, the fpirits  of hartf-
horn,fal volatile oleofum, horSe-radifh, &c. may be  taken inwardly;
the disordered parts, at the  Same time, may be frequently rubbed'
with frefh nettles or fpirit of fal ammoniac.  Blifters and finapifms
applied to the parts will likewiSe be oS uSe, as alSo warm bathing,
eSpecially in the natural hot badis.
               CHAPTER   XL VII.


                  Of a Schirrus and- Qancer.

 A SCHIRRUS is a hard  indolent tumour Seated in fome of?
       the glands; as the breafts, the arm-pits, &c. IS the tumour
 becomes large, unequal, of a livid, blackifh, or leaden colour, arid
 is attended with violent pain, it gets the name of an occult cancer.
 When  the fkin  is broken, and  afanies or ichorous matter, of an
 abominably foetid fmell is  difcharged from the fore, it is called an
 open or ulcerated cancer.  Perfons after the age of forty-five, par-
 ticularly women, and thofe who lead an indolent  fedentary life, are
 moft fubjea to this difeafe.
   CAUSES.-----It is often owing to fuppreffed evacuations; hence
 it proves frequently fatal to women of a grofs habit, particularly
 old maids  and widows,  about  the  time when the menftrual flux
 eeaSes.  It may be occafioned by exceffive fear, grief, anger, religious
 melancholy, or any of the depreffing paffions. Hence, the unfortu-
 nate,  the  cheleric,  and thofe perfons  who  devote themfelves to a
 religious life in convents or  monafteries, are often  affliaed  with
 it.  It may be occafioned by the long-continued ufe of food that is
 too hard of digeftion, or of an acrid nature; by barrennefs; celibacy;
 indolence; cold; blows;  friaion;  preffure,or the like.  Women
 often fuffer from the laft of thefe, by  means of their ftays, which
- fqueeze and comprefs their breafts fo as to occafion great mifchief.
 Sometimes the difeafe is owing to an hereditary difpofition.
   SYMPTOMS.-----This diforder feems often very trifling at the
 beginning. A hard tumour about the fize  of a  hazle-nut, or per-
 haps fmaller,  is generally the firft Symptom.  This will often con-*
 tinue for a long time without feeming to increafe, or giving the pa-
 tient great uneafinefs ;  but if the conftitution be  hurt, or the tu- 
3*6             SCHIRRUS AND CANCER.

mour irritated by preffure, or improper  treatment of any kind, it
begins to extend itfelf towards the neighbouring parts, by pufhing
out a kind of roots or limbs.  It then gets the name of cancer, from
a fancied refemblance between the limbs and the claws of a crab. -
The colour of the fkin begins to change, which is firft red, aSterwards
purple,'then bluifh, livid, and at laft black.  The patient complains
oS heat, with a burning, gnawing, fhooting  pain. The tumour is
Tfery hard, rough, and unequal, with a protuberance, or riflng, in
the middle; its Size increafes daily, and the neighbouring veins be-
come thick, knotty, and oS a blackifh colour.
   The fkin at length gives way, and a thin, Sharp ichor begins to
flow, which corrodes the neighbouring parts till  it  Sorms a large
unfightly ulcer.  More occult cancers arife, and communicate widi
the neighbouring glands. The pain and ftench become intollerable ;
the appetite fails; the ftrength  is exhaufted by a  continual heaic
fever; at laft, a violent haemorrhage, or  diScharge oS blood, Srom
fome part oS the body, with faintings, or convulfion  fits, generally
put an end to liSe.
   REGIMEN.----The diet ought tob_ light, but nourifhing. All
ftrong liquors,  and high-SeaSoned  or Salted provifions, are to be
avoided.  The patient may take as much exerciSe as he can eafily
bear ; and  fliould uSe every method to  divert thought, and amuSe
his Sancy. All kinds of external  injury  are carefully to be guarded
 againft, particularly of the affeaed part, which ought to be defen-
ded from  all preffure, and even  from the external air, by covering
 it with fur or foft flannel.
   MEDICINE.-----For this difeafe no  certain remedy is known.
 Its progrefs may fometimes be retarded, and fome of its moft dif-
 agreeable fymptoms mitigated, by proper applications. One misfor-
 tune attending the difeafe is, that the patient often  conceals it too
 long. Were proper means nfed in due time, a cancer might often
 he cured ; hut after the diforder has arrived at a certain height, it
 generally Sets all medicine at defiance.
    When a fehirrous tumour is firft difeovered, the patient ought to
 obferve a proper regimen, and-to take twice or thrice a-week, a dofe
 of common purging mercurial pills. Some blood may alfo be let, and,
 the part affeaed may be gently rubbed twice a-day with a little of
 the mercurial ointment, and kept warm with fur or flannel.  The
 food muft be light, and an Englifh pint of the decoaion of woods
 or farfaparilla may be drank daily.  I have fometimes difcuffed hard
 tumours, which had the appearance of beginning cancers, by a courfe
 of this kind.
    Should the tumour not yield to this treatment, but become larger
 and harder, it  will be proper to  extirpate it, either  by the knife cr
 cauftic.  Indeed, whenever this can be done with fafety, the fooner
 it is done the better. It can anfwer no purpofe to extirpate a cancer
 .after the conftitution is ruined, or the whole mafs of humours cor-
 rupted by it. This is the common  way, which makes the operation 
            SCHIRRUS  AND CANCER.           327

fo feldom Succeed.   Few people will Submit to die extirpation till
death flares them in the face ;  whereas, if it were done  early, life
would not be endangered by the operation, and it would generally
prove a radical cure.
   When the cancer is fo Ctuated that it cannot be cut off, of .if die
patient  will not fubmit to the operation,  fuch medicines as will
mitigate or  relieve the moft urgent fymptoms may be ufed.  Dr.
Home fays, that half a grain of the corrofive Sublimate of mercury,
diffolved in a proper quantity of brany,  and taken night and mor-
ning, will often be of fervice in cancers of the face and nofe..  He
likewife recommends an infufion of the folanum, or ni^ht-fhade, in
cancers of the breafts.
   The medicine moft in repute for  this  difeafe is hemlock.  Dr.
Stork, phyfician at Vienna, has of late recommended the extraa of
this plant as very efficacious in cancers of every kind-.  The Doaor
fays, he has given fome hundred weights of it without ever hurting
;any body, and often with manifeft advantage. He advifes the patient,
however, to begin with very fmall dofes, as two  or three grains,
and to increafe the dpfe. gradually till fome good effect be perceived,
and there to reft without further increafe. From two or three grains
at firft, he fays  he. has  increafed  die dofe  to two,  three,  or four
drachms a-day, and finds that fuch dofes may be continued for  fe-
veral weeks without any bad confequences.
  .-The regimen which he recommends during the ufe of the medi-
cine,is to avoid farinaceous fubftances not fermented, and too acrid
 aromades.  He fays, good wine will not be hurtful to thofe who  are
 accuftomed to it, nor a morderate ufe of acids ;  and adds, that  the
 patient fhould live in a nine, free air, and  keep his mind as quiet
 and cheerful as poffible.
   He-docs not pretend,to fix the time in which a cancer may be re-
 Solved by die ufe of hemlock, but fays, he has given it Sor above
 two years in large doSes without any apparent benefit; nevertheless,.
 the patient  lias been cured by perfifting in the uSe of it for half a-
 year longer-  This is, at leaft encouragement, to give it a fair trial.
Though we are far from thinking hemlock  merits thofe extravagant
 encomiums' which he has bellowed upon it, yet, in a difeafe which
 has fo Jong baffled the boafted powers of  medicine, ought always
 to be tried.
   The powder  of  hemlock is by fome preferred  to  the  extraa.
 They are both made of the frefh leaves, and may be ufed  nearly in
 the fame manner. Dr. Nicholfon of Berwich, fays, he gradually in-
 creaSed the  doSe of the powder from a few grains to half a drachm,
 and gave near four drachms of it in  the day, with remarkably good
 effeas. The hemlock may alfo be ufed externally either as a poul-
 tice or "fomentation. Tl.e fore  may likewiSe be kept clean by injeft-
 ing daily a  ftrong decoaion of the  tops and leaves into it.
   Few things contribute more to the healing of Soul Sordid ulcers cf
any kind than keeping diem thoroughly.clean. This ought never to 
328          SCHIRRUS AND CANCER.

'be negfeaed.  The beft application for this purpofe feems to be the
carrot poultice.   The root of the common carrot may be grated,
and moiftened with as much water as will bring it to the confit-
tence of a poultice or cataplafm. This muft be applied to the fore,
and renewed twice a-day.  It generally  cleans the fore, eafes the
pain, and takes away the difagreeable fmell, which are objeas of
no  fmall importance*.
  Wort, or an infufion of malt, has been recommended, not only as a
proper drink, but as a powerful medicine, in this difeafe.  It muft be
frequently made frefh, and the patient may take it at pleafure. Two,
three, or even four Englifh pints of it may be drank every day for
a confiderable time. No benefit can be expeaed from any medicine
in this difeafe, unlefs it be perfifted in for a long time. It is of too
obftinate a nature to be foon removed; and, when it admits of a
cure at all, it muft be brought about by inducing an almoft total
change of the habit, which muft always be a work of time.  Setons
or iffues in  the neighbourhood of the cancer have fometimes good
effeasf.
  When all  other  medicines fail, recourfe muft be had to opium^
as a kind of folace.  This will not indeed cure  the difeafe, but it
will eafe the  patient's agony, and render  life more tolerable while it
continues.
  To avoid this diforder, people ought to ufe wholefome food ; to
take fufficient exercife in the open air; to be as eafy and cheerful
as poffible; and carefully to guard againft all blows, bruifes, and
every kind of preffure upon the breafts or other glandular parts^
                 % London Medical Effays.

  f In a cancer which had fet all medicines, and even furgery, at de-
fiance, I lately faw remarkable effefts from an obftinate perfeverance
in a courfe of antifeptics.  I ordered the deep ulcers to be wafhed to
the bottom, by means of a fyringe, twice or thrice a-day, either with
an infufion of the bark, or a deco&ion of carrot, and that the patient
fliould take, four or five times a-day, a glafs of good wine, with half a
drachm  of the beft powdered bark in it.  The fores, after being wafh-
ed, were likewife fprinkled with the fame powder.  When the patient
began this courfe, her death was daily expefted.  She continued it for
above two years, with manifeft advantage ; but being told by an emi-
nent furgeon, that the bark would not cure a, cancer, and that the fores
ought not to be wafhed, fhe difcontinued  the  practice, and died in a
few weeks.  This courfe was not expefted to cure the  cancer, but to
prolong  the patient's life, which it evidently did almoft to a miracle.

   i  As hemlock is £he principal medicine recommended in this drfeafe,
we would have given fome directions fori e gathering and preparing
of that plant; but as its different preparations are nowkeptinthefhops,
it is  much fafer for  people to get them there, with  proper directions
for ufing them. 
C  '3*9   i
                 CHAP  T  E  R   XLVlfr.

                            Of Poifons.

        EVERY perfon ought, in fome meafure, to be acquainted with
         die nature and cure of poifons.  They are generally taken un-
   awares, and their effeas are often So Sudden and violent, as not to
   admit oS delay, or time to procure the affiftance of phyficians. Hap-
   pily nO  great degree oS medical knowledge is here neceffary ; the
   remedies for moft poifons being generally at hand*, or eafily obtain-
   ed, and nodiing but common prudence needful in the application
>   of them.
     The vulgar notion, that every poiSdn is aired  by fome counter*-
   poifon, as a fpecific, has done much hurt. People believe they carl
   do nothing for the patient, unlefs they know the particular antidote
   to that'kind of poifon which he has taken. Whereas the cure of
   all poifons taken into the ftomach, without exception, depends chief-
   ly on discharging them as foon as poffible.
     There is no cafe wherein die indications of cure are more obvious!
   Poifon is feldom long in the ftomach before it occafions ficknefs,
   with an inclination to vomit.  This fhews plainly what [ ought to be
   done. Indeed common fenfe diaates to every one, that, if any thing
   has been taken'into the ftomach  which endangers life, it ought im-
   mediately to be difcharged;  Were this duly regarded, the danger
  > arifing from poifons  might generally be • avoided.  The  method of
   prevention  is obvious,  and  the means  are in the  hands of every
  ' one.
     We fhall not take up the reader's time With a detail* of the  ridi-
   culous notions which have  prevailed among ignorant people in dif-
   ferent ages  with regard to poifons; neither fhall we mention the
   boafted antidotes, which have been recommended either for pre-
 '  venting or obviating their effeas; but  fhall point out the poifons
   moft common in this country, and the means of avoiding their dan-
   gerous confequences.
     Poifons either belong to the mineral, the vegetable, ot the animal
   kingdom.
     Mineral poifons are commonly of an acrid or corrofive quality §
   as arfenic, cobalt, the corrofive Sublimate of mercury, &c.
     Thofe of  the vegetable kind are  generally of  a narcotic or ftu-
  pefaaive quality; as poppy, hemlock, henbane, berries of the dead-
  ly night-Shade, &c.
     Poifonous animals communicate their infaaion either by the bite
  or Sting.  This poifon is very different from the former, and only
  produces" its effeas when received into the body by a wound.
     MINERAL  PblSONS.----Arfenic  is the  moft commdh of
  this ciafs ; and, as the whole  of them are pretty nniilar both in dieit
                                 T 2 
33©                   POISONS.

effeas and method of cure, what is faid with refpea to it will be
applicable to every other Species oS corrofive poiSon*.
  When a perSon has taken arferiic,' hc-ifoon perceives  a burning,
heat,  and a violent pricking pain in his ftomach and bowels, with
an intolerable thirft, and an inclination to vomit.  The tongue and
throat feel rough and dry ; and, if proper means be not foon adminif-
tered, the patient is Seized with great anxiety, hiccupping, faintings,
and coldnefs of the extremities.   To  thefe fucceed black vomits,
foetid ftools, with a  mortification of the ftomach and inteftines,
which are the immediate forerunners of death.  !
   On the  firft appearance  of thefe fymptoms, the patient  fhould
drink large quantities of new milk and fallad-oil till he vomits ; or
he may drink warm water mixed with oil.   Fat broths are likewife
proper, provided they can be got ready in time. Where no oil is to
be had, frefh butter may be melted and mixed with the milk or wa-
ter. Thefe thing are to be drank as long as the inclination to vomjt
continues.  Some have drank eight or  ten Englifh quarts before the
vomiting ceaSed ; and it is never Safe to leave off drinking while one
particle of the poifon remains in the ftomach.
   Thefe oily or fat fubftances not only provoke vomiting, but like-
wife blunt  the acrimony of the poifon, and prevent its wounding
the bowels ; but if they fhould not make  the  perfon vomit, half a
drachm, or two feruples  of the powder of ipecacuanha muft be
given, or a few Spoonfuls of the oxymel or vinegar of Squills may be
mixed with the water which he drinks.  Vomiting may likewiSe be
excited, by tickling the infide of the throat with  a feather.  Should
thefe  methods, however, fail, half a drachm of  white vitriol, or five
or fix grains of emetic tartar, muft be adminiftered.
   If  tormenting pains are felt in the lower belly, and there is reafon
to fear that the  poifon has got down  to the inteftines, clyfters of
milk and oil muft be very frequently thrown up ; and the patient
muft  drink emollient decoaions of barley, oat-meal, marfh-mallows,
and fuch-like. He muft likewife take an infufion of fenna and man-
na, a folution of Glauber's falts, or fome other purgative.
   After the poifon has been evacuated, the patient ought, for fome
time, to live upon fuch things as are of a healing and cooling quality;
to abftain from flefh and all ftrong liquors, and to live upon milk,
broth, gruel, light puddings, and other fpoon-meats of eafy digeftion.
His drink  fhould be barley-water, linfeed-tea, or infufions of any
of the mild mucilaginous vegetables.
   VEGETABLE POISONS, befides heat and pain of the -fto-
mach, commonly  occafion fome degree of giddinefs, and often  a
kind  of ftupidity or folly.  Perfons who have  taken  thefe poifons
muft  be treated in the fame manner as for the mineral or corrofive.

  •35- Corrofive fublimate  is an exception when this poifonhas been tak-
en, the patient ought to drink large quantities of  pot-am or fait of tar-
tar, diffolved in water to re-compofe the poifon and rend er it inaaive. 
BITES OF POISONOUS ANIMALS.
  Though the vegetable poifons, when allowed tq remain in the fto-
wiach, often prove fatal;  yet the danger is generally over as foon as
they are difcharged. Not being of fuch a cauftic or corrofive nature,
they are lefs apt to wound or inflame the bowe'ls than mineral fub-
ftances : no time ought to be loft in having them difchargedw •
  Opium, being Srequently taken by miftake, merits particular at-
tention. , It is uSed as a medicine both in a Solid and liquid Sorm,
which latter commonly goes by the name of  laudanum.   It is, in-
deed, a valuable medicine when  taken in proper quantity ; but a&
an over-doSe proves a  ftrong poiSon, we fhall point  out its common
effeas, together with the method of cure.
  An over-dofe of opium generally occafions, great drowfinefs, with
ftupor and other apopfeaic fymptoms. Sometimes the perfon has fo
great an inclination to fleep, that it is almoft impoflible to keep him
awake. Every method muft, however, be tried for this purpofe. He
fliould be  toffed, fhaked, and moved about.   Sharp blifters fhould
be applied to his legs or  arms,  and Itimulating medicines, as falts
oS hartfhorn,  &c. held under his noSe. It will alfo be proper to let
blood. At the Same time, every method mult be taken to make  him
dichargethepoifbn. This may be done in the manner direaed above,
viz. by the ufe of ftrong vomits, drinking plenty  of warm water
with oil, Sec.
  Mead, befides vomits in this  cafe, recommends  acid medicines
with lixivial  falts.  He fays, that he h^s often given" fait  of worm-
wood mixed with juice of lemon in repeated dofes with  great
fuccefs.
  If the body fhould remain weak and languid after the poifon has
been difcharged, nourifliing diet and cordials will  be proper; but
when there is reafon  to fear that  the ftomach  o:  bowels are in-
flamed, the greateft clrcumfpe&ibn is neeeflary, both with regard
to food aruvl medicine.
              Of the Bites of Poifonous Animals.

   WE fhall begin with the bite of a mad dog, as it is both the moft
common and dangerous animal-poifon in this country.
   The creatures naturally liable to contraa this difeafe are, as far as
we yet know, all of the dog kind, viz. foxes, dogs, and wolves.—
Hence it is called the rabies canina, or dog madnefs.  It to feldom
happens  that any perfon  is bit by the firft, that they fcarce deferve
to be taken notice of. If fuch a thing fliould happen, the method
of treatment is precifely the fame as for the bite of a mad dog.,
   The fymptoms cf madnefs  in a dog are as follow : At  firft he
looks  dull, Shews an averfion to food and company: he does not
lark as ufucl,  but feems to murmur, is peevifli, and apt  to bite 
332     BITES  OF POISONOUS ANIMALS.

ftrangers : his ears  and tail droop more than ufual, and he appears
drowfy: afterwards he begins to loll out his tongue, and froth at
the mouth, his eyes  feeming heavy and  watery : he now, if not
confined, takes off, runs panting along with a kind of dejected.air,
and endeavours to bite every one he meets.   Other dogs are faid to
fly from him. Some think this a certain Sign of madneSs, Suppofing
that they knew him by the Smell;  but it is not to be depended on.
If he efeapes being killed, he feldom runs above two or three days,
till he dies exhausted with heat, hunger, and fatigue.
  This difeaSe  is moft Srequent aSter long, dry, hot SeaSons ; and
fuch dogs as live  upon putrid,  ftinking carrion, without having
enough qf frefh-water, are moft liable to it.
  When any perfon has been bit by a dog, the ftriaeft inquiry ought
to be made, whether the animal was really mad.  Many diSagreeablc
conSequences ariSe  Srom negkaing to aScertuin this point.  Some
people have lived in continual anxiety for many years, becaufe diey
had been bit  by a  dog which they believed to be mad ; but as he
had been killed on  the fpot, it was impoflible to aScertain the Sacl.
This fhould induce us, inftead oS killing a dog the rnoment he has
bit any perSon, to do all in our power to keep him alive, at leaft till
we can be certain whether he be mad or not.
  Many  circumftances may contribute to make people imagine a
dog mad.  He looScs his matter, runs about in queit of him, is fet
upon by other dogs, and perhaps by men.  The creature thus frigh-
tened, beat and abufed, looks wild, and lolls out  his tongue as he
runs along. Immediately a  crowd  is after him ; while he, finding
himfelf clofelypurfued, and taking every one he meets for an ene-
my, naturally attempts  to bite him in felf-defence.  He foon gets
knocked on the head, and it pafles  currendy that he was mad, as it
is then impoflible to prove the contrary.
  This  being the true hiftory of,  by far, the greater part of thofe
dogs which pafs for mad, is it  any wonder that numberlcfs whim:
fical medicines have been extolled for preventing the effeas of their
bite ? This readily accounts for die great variety  of  infallible re-
medies for the bite of a  mad  dog, which are to be n-.ct with in al-
moft every family.  Though net one in a thoufand has any claim to.
merit, yet they are all fupported by numberleSs vouchers. No won-
der that imaginary diSeaSes fhould  be cured by imaginary remedies.
In  this  way, credulous people firft impoSe upon themSelvcs, and
then deceive others. The Same medicine which was SuppoSed to pre-
vent the effeas of the bite, when  the dog was not mad, is recom-
mended to a perfon who has had the misfortune to be  bit by a dog
that was really mad. He takes it, trufts to it, and is undone.
   To thefe miftakes we muft impute the Srequent ill SucceSs of the
medicines, ufed for preventing die effeas  of the bite of a mad dog.
It is not owing fo much to a defea in medicine, as to wrong appli-
cations. If proper medicines were adminiftered immediately after
fiie bite is  receivedj and continued for a Sufficient length of time,
y/e fhould not loSe one in a thoufand of thofe bit by a mad dog, 
        BITES OF POISONOUS ANIMALS.      333

  This poifon is generally communicated by a wound, which, never-
theless, heals as foon as a common wound : but afterwards it begins
to feel painful,  and as ths pain fpreads towards the neighbouring
parts, the perfon becomes heavy and liftlefs.   His fleep is unquiet,
with frightful dreams; he fighs, looks dull, and loyes folitude. Thefe
are the forerunners, or rather the firft fymptoms of that dreadful
difeafe, occafioned by the bite of a mad dog.   But as we do not p*q-
pofe to treat fully of the difeafe itfelf, but to point out the methcdof >
preventing it, we fhall not take up time in fhowing its progrefs from
the firft invafion to its commonly fatal erid.
  The common notion, that this poifo i  may lie in the body for
many years, and afterwards prove fatal, is both hurtful and ridicu-
lous.  It muft render perfons bit, very unhappy, and can have no
good effeas. If the perfon  takes proper medicines for forty days
after the time of his being bit, and feels  no fymptoms of the difeafe,
there is reafon  to believe him out of danger.
  The medicines recommended for preventing the effeas of the
bite of a mad dog, are chiefly fuch as promote the different fecre-
tions, and antifpafmodic^.
   Dr. Mead recommends a preventative  medicine, which he fays
he never knew fail, thifegh in the fpace of thirty years he had ufed
it a thoufand times. It is as follows :
   " Take afh-coloured ground liver-wort, cleaned, dried, and pow-
dered, hdf an ounce ; of black pepper  powdered, a quarter of an
ounce.   Mix thefe well together, and divide the  powder into four
dofes ; one of which muft be taken every morning fafting, for four
mornings fucceffively, in half an Englifh pint of cows milk warm.
   " After thefe four dofes are taken, the patient muft go into the
cold bath, or a cold Spring or river, every  morning fafting, for a
month ;  he muft be dipped all over, but not  flay in (with  his head
above water) longer than half a minute, if the water be very cold.
After  this he muft go in three times a-week for a fortnight longer.
  . " The perSon muft be bled berore he begins to uSe the medicine*."
   We Shall next mention the famous Eaft-India Specific, as it is cal-
led. This medicine is compoSed oS cinnabar and muflc. It is efteem-
ed  a great antiSpaSmodic; and, by many, extolled as an infallible
remedy for preventing the effeas of the bite of a mad dog.
   « Take native and feaitious cinnabar, of each twenty-four grains,
mufk fixteen grains.  Let thefe be made into a fine powder, and
taken in a glafs  of arrack or brandy."
   This fingle dofe is faid to fecure the perfon for thirty days, at the
end of which it muft be repeated ; but if he has  any fymptoms  of
the difeafe, it muft be repeated in three hours.
  #• Though we give this prefcription on the credit of Dr. Mead, yet
we would not advife any perfon,  who has reafon to believe thm: lie has
been bit by ado* which was really mad, to truft to it alone.  .Mead
was aaable phylician, but lie feems to have been no great phyiofopher,
and was fometimes the dupe of his own credulity.  . 
 334      BITES OF POISONOUS ANIMALS.

    The following is likewife reckoned a good antifpafmodic medicine:
    " Take of Virginian fnake-root in p'owder, half a drachm, gum
 afafcetida twelve grains, gum camphire feven grains ;' make thefe
 into a bolus with a little fyrup of faffron."
    Camphire may alfo be given in the following manner:
    " Take purified  nitre,  half an ounce, Virginian fnake-root in
 powder, two drachms, camphire, one drachm ;  rub  them together
 in a mortar, and divide the whole into ten doSes."
    Mercury is likewiSe recommended as of great  efficacy, both in
 the prevention and cure of this kind of madnefs.  When ufed as a
 preventative,  it will be fufficient to rub daily a drachm'of the oint-
 ment into the parts about the wound.
   Vinegar is  likewife of confiderable fervice, and fhould be taken
 freely, either in the patient's food or drink.
   Thefe are the principal  medicines recommended for  preventing
 the effeas of the bite of a mad dog.  We would not advife people td
 trutt to any one of them ; but from a proper combination of their
 different powers, there is the greateft reaSon to hope Sor SucceSs.
   The great error in the  ufe of thefe medicines lies,  in not taking
 them for a fufficient length of time. They are ufed more like charms,
 lhan medicines intended to produce any change in the  body. To this,
 and not to the infufficiency of the medicines, we muft impute their
 frequent  want of fuccefs.
   Dr. Mead fays, that the virtue of his  medicine confifts hi promo-
 ting urine. But how a poifon fhould be expelled by urine, with only
 three or four dofes of any medicine, however powerful, it is not eafy
 to conceive. More time is certainly neceffary, even though the me-
 dicine were rnore powerful than that which the Doaor preferibes.
   The Eaft-India Specific  is ftill more exceptionable en this  ac-
 count.
   As theSe and moft other medicines, taken  fingly, have frequent-
 ly been found to fail, we Shall recommend the following courfe  :
   If a perSon be  bit in a flefhy part, where  there is no hazard of
 hurting any large blood-veflbl, the parts adjacent to the wound may
 be immediately cut away*.  But if this be not done foon after the
 bite has be in received, it will be better to omit it.
  The wound may be wafhed with fait and water, or a pickle made
 of vinegar and  fit, and afterwards dreffed tv.ice a-day with yellow
 bafilicon,  mixed v/ith the red precipitate of mercury.
  The patient  fhould begin to ufe either Dr. Mead's medicine, or
 fome of the others mentioned above. If he takes MeadVmedicine,
 he may ufe it'as the Doaor directs for four days fucceffively. Let
 him then emit it for two or three day's, and  again repeat the fame
 number of dofes as before.
  During thi-i courfe, he muft rub into the parts about the wound
    * Cautic  his b~ea recommended to be applied to the part,  but
 this fliould never b^ employed wucn the knife can b.- ufed. for it is
 i.able to  fni.'lrute  the  ii.Tontion by net de!tr;>yn£ die  whole  of  the
wounded part.  '         1- '.'../ 
         BITES OF POISONOUS ANIMALS.     ,555

daily, one drachm of the  mercurial ointment. This  may be done
for ten or twelve days at leaft.
   When this courSe is over, he may take a purge or two, and wait
a few days till the effea oS the mercury be gone off.■. He muft then
begin to uSe  the cold bath, into which he may  go every morning
for five or  fix weeks.  IS he fhould Seel cold and chilly for a long
time after coming out of the cold bath, it will be better tp ufe a te-
pid one, or to have the water a little warmed.
   In die mean time, we  would advife him not  to leave off all in-
ternal medicines, but to take either one of the bolufes of fnake-root,
afafcetida,  and camphire; or one of the powders of nitre, camphire,
and  fnake-root, twice a-day. Thefe may be ufed during the whole
time he is  bathing.
   During the ufe of die mercurial ointment,' the patient muft keep
within  doors, and take noduiig cold.
   A proper regimen muft be obferved throughout the whole courfe.
The patient  fhould abftain from flefh, 'and all falted and high-fea-
foned prcvifions.  He muft avoid ftrong liquors, and live moftly up-
on a light and rather fpare diet. His mind fhould be kept as eaSy and
 cheerful as poffible,  ;md all  exceffive  heat, and  violent  paffions
 avoided with the utmoft  care.
   1 have never feen this courfe. of medicine, with proper regimen,
 fail  to  prevent the hydrophobia, and cannot help again obferving,
 that the want of fudceSs muft generally  be owing either to the ap-
 plication oS improper medicines, or not ufing proper  ones for a fuf-
 ficient length of time.
   Mankind are extremely fond of every thing that promifes'a hid-
 den or miraculous cure.  By trufting to theSe, they often lofe  their
 lives, when a regular courfe of medicine would have rendered them
 abfolutely fafe. This holds remarkably in the prefent cafe.  Num-
 bers of people, for example, believe if they or their cattle, be  once
 dipped in  the fea, it is fufficient; as if the Salt water were  a charm
 againft the  effects  of the bite.  This, and fuch like whims,  have
 proved fatal to many.
   It is a common notion,  if a perfon be bit by  a dog  which is not
 mad, that, if he fhould go  mad afterwards, the perfon would be af-
 feaed with  the diforder at the fame time; but this notion  is too
 ridiculous to deferve a ferious confideration. It  is  a good rule, how-
 ever, to avoid dogs as much as poffible,  as  the difeafe is often  upon
 them for fome time before it's violent fymptoms appear. The hydro-
 phobia has been occafioned by the bite  of a dog which fhewed no
 otherlfymptoms of the difeafe but liftlefTnefs and a fullen difpofition.
   >Thjough we do not mean to treat fully'of the cure of the hydro-
 phobia, yet we are far from reckoning it incurable. The notion that
 this difeafe could not be cured, has been produaive of horrid con-
 fequences. It was ufual either to abandon the unhappy perfons, as
 foon as they were feized with the difeafe, to their fate, to bleed them.
 to death, or to fuffocatc diem between matraffes or feather beds, &c. 
3#     BITES OF POISONOUS ANIMALS.

This condua certainly deferved: the fbvertft p'unifhment! We hope,
for the honour of human nature, it Will never again be heard of.
   I have never had an Opportunity of treating this  difeafe, and
therefore can" fay nothing cf it from my own experience ; but Dr.
Tiffot fays, it may be cured iri the following manner :
   i. The patient- muft  be bled to a  Considerable  quantity ; and
this may be repeated twice, thrice, or even a fourth time, if circum-
ftances require it.
   2. The patient fhould be put, if poffible, into a warm bath ; and
this 'fhould be-uSed twice a-day.
   3: He  fhould  every day receive  two, or even three emollient
clyfters'.
   4. The wound, and the  parts adjoining to it, fhould be rubbed
with the mercurial ointment twice a-day.
   5. The whole limb which contains the wound fliould be" rubbed
with dil, and be wrapped'up in an oily'fTanuel.
   6. Every three hours a dofe of Cob's powder Should be taken in
a cup'of-the ittStifion  of lime-tree and'elder-flowers.  This powder
is made, by rubbing together in a mortar, to a very fine powder, of
native and fa*aitious  Cinnabar, each' twerityt-fotir grains; of mufk,
fixteen grains*.
   7. The following bolus is to be given every 'night, and to be re-
peated in the morning, if'the patient is not eafy, wafhing it down
with thevinfuffoft mentioned' above : Take one drachm of Virginian
fnake-root in powder-; of camphire and afafcetida, ten grains each;
of .opium, one grain; and, with a fufficient quantity  of conferve,
of rob of elder, make a bolus.
   &*. If there be a gr6at naufea at the ftomach, with a bitternefs in
the mouthy thirty-five or Sorty grains oS ipecacuanha, in powder,
may be taken for a voniit.
   9.. The patient's food^  if he takes any, muft be light; as pana-
do, foups made of farinaceous or mealy vegetables, &c.
   1 o.  If the patient fhould long continue weak, and fubjea to ter-
rors, he may take half a drachm of the Peruvian bark thrice a-day;
   The next poifonous animal which we fhall mention is the VIPER.
The greafe of this animal rubbed into the wound is faid to cure the
bite. Though  that is all die viper-catchers generally do when bit,
we fhould not think it fufficient for the bite of an enraged viper. It
would  furely be riiore fafe to have the wound wellfuckedf, andaf-
  * The Ormikirk medicine, as it is called, feems to me to confift chief-
ly of cinnabar.  Though it is faid to be infallible, as a preventative; yet
I would not advife any one to trult to italone. Indeed, it  is ordered to
be t.vten in a manner which gives it mote the appearance of a chdrm
than of a medicine.  Surely, if a medic ine"is to produce any change in
the body, it muft be taken for fome confiderable time, and in fufficient
quantity.
  t The practice of fucking out poifons is very ancient ; and indeed
nothing can bemore rational. Where-the bite cannot be  cut out, this
is the moft likely way for extracting the poifon. There can be no dan-
ger in performing this office, as the poifon dees no harm, unlefs it be 
               . VENEREAL  DISEASE.              33?

eerwards rubbed with warm Sallad-oil. A poultice of bread and milk,
foftene4  with fallad-oil, fhould likewife be  applied to the wound.;
and the  patient ought to  drink freely of vinegar-whey, or water-
gruel with vinegar in it, to make him fweat. Vinegar is one of the
beft medicines which can be ufed in any kind of poifon, and ought
to be taken very "liberally.  If the patient be  fick, he may take a yo-
mit. This courfe  will  be  fufficient to  cure the bite of any of the
poifonous animals of this country.
   With regard to poifonous infects, as the bee, the wafp, the hornet,
&c. their flings are feldom attended with danger,  unlefs when a
perfon happens to be ftung by a great -number of them at the fame
time ;  in which Cafe fomething fhould be done to abate the inflam-
mation and Swelling*  Some,  for this purpofe, apply honey, others
lay pounded parfley to the part.  A mixture of vinegar and Venice
treacle is likewife recommended ;  but I have always found rubbing
the part with warm fallad-oil fucceed very well. Indeed, when  the
Stings  are fo numerous as to endanger  the patient's life, which is
fometimes the cafe', he muft not only have oily poultices applied to
the part,  but fhould likewife be bled, and take fome cooling  medi-
cines, as  nitre, or cream of tartar,  and fhould drink plentifully of
diluting liquors.                            ,
   It is the happinefs of this ifland to have very  few  poifonous ani-
mals, and thofe which we havei are by no means of the moft virulent
kind.  Nine-tenths of the  effeas attributed  to poifon or venom in
this country, are really other difeafes, and proceed from quite dif-
ferent caufes.
   We cannot, however, make the fame obfervation  with regard to
poifonous vegetables.   Thefe abound every where, and prove often
fatal to the ignorant and unwary.  This,  indeed,  is chiefly  owing to
careleffneSs. Children ought early to.be cautioned againft eating any
kind of fruit, roots, or berries, which they do not know, and all poi-
fonous plants to which they can have accefs, ought, as far as poffible,
to be destroyed. This  would not be So difficult  a tafk as Some peo-
ple imagine.
               CHAPTER   XLIX*

                  Of the  Venereal Difeafe.
   IT is unSortunate Sor the unhappy perSons who cohtraa this diS-
    eaSe, that it lies under a Sort of" diSgrace. This renders difguife
neceffary,  and makes the patient either conceal his  diforder altoge-

taken into the body by a wound.  The perfon'whd fucks the wound
ought however to wafli his mouth frequently with fakd-oil, which will
fecure him from even the leaft inconveniency.  The  Pfylli in Africa,
and the Marfi in Italy, were famed for curihgthe bites of poifonous
animals by fucking  the wound;  and we are told that the Indians in
Korth-America practife the fame/it this day. 
338         VIRULENT  GONORRHCEA.

ther, or apply to thofe who promife a fudden and fecret cure ;  but
who in faa only remove the fymptoms for a time, while they fix the
diSeaSe deeper in the habit. By this means, a flight infeaion, which
might have been eafily removed, is often converted into an obftinate
and fometimes incurable malady.
   Another unfavourable circumftance attending this diSeaSe is, that
it affumes a variety of different Shapes, and may with  more propri-
ety be called an affemblage oS difeafes than a fingle one.  No two
diSeaSes can require a more different method of treatment than this
does in its different ftages.  Hence, the folly and danger oS trufting
to any  particular noftrum  Sor the  cure oS it. Such noftrums are
however generally adminiftered in the Same manner to all who ap-
ply for  them, without the leaft regard to the ftate of the difeafe, the
conftitution of  the patient, the degree of infeaion, and a thoufand
other circumftances of the utmoft importance.
   The venereal difeafe  may be communicated  to the innocent as
well as the guilty. Infants,  nurfes,  midwives, and married  women
whofe hufbands lead diffolute lives, are often affeaed with it, and
frequently lofe their lives by not being aware of their danger in  due
time. The condition of fuch perfons will certainly plead our excufe,
if any excufe be neceffary, for endeavouring to point out the fymp-
toms and cure of this too common difeafe.
   To enumerate all its different fymptoms, and to trace the difeafe
minutely through its various ftages, would require a much larger
fpace than falls to this part of my  fubjea.  I therefore confine my
obfervations  chiefly  to circumftances of importance, omitting
 fuch as are  trifling,  or which occur but  feldom.
                  The Virulent Gonorrhoea

  IS an involuntary difeharge of infeaious matter from the parts of
generation in either fex.  It generally makes its appearance within
eight or ten days after the infeaion has been received :  fometimes
in two or three days, and at  other times not for four or five weeks.
Previous to the difeharge,  the patient feels an itching, with a fmall
degree of pain in the genitals. Afterwards  a thin glary matter be-
gins to diftil from the urinary paffage, which ftains the linen,  and
occafions a fmall degree of  titillation, particularly in the time of
making water; this arifes at length to a degree of heat and pain,
which are chiefly perceived about the extremity of the urinary paf-
fage, where a flight degree of rednefs and inflammation likewife be-
gin to appear.
  As the diforder advances, the pain, heat of urine, and running
increafe, while frefh fymptoms daily enfue.  In men, the ereaions
become painful and involuntary, and are more frequenj and lading 
VIRJJLENT GONORRHOEA.
 tlian when natural.  This fymptom is moft troublefome when the
 patient is warm in bed. The pain which was at firft only perceived
 towards the extremity, now  begins to reach all up the urinary paf-
 fage, and is moft intenfe juft after the patient has done making wa-
 ter.  The running gradually grows yellow, and  at length puts on
 the appearance of matter.
   When the diforder has arrived at its height, all  the fymptoms are
 more intenfe ; the heat of urine is fo great, that the patient dreads
 the making water ;  and, though he feels a conftant inclination this
 way, yet it is rendered with the greateft difficulty, and oSten only
 by drops  : the involuntary ereaions now become extremely pain-
 Sul and Srequent; there is alSo a pain, heat, and  fenfe  of  fulnefs
 about the feat, and the running is plentiful and Sharp, of ;i brown,
 greenifh, and fometimes of a bloody colour.
   By a proper treatment, the violence of the fymptoms gradually
 abate ;  the heat of urine goes off; the involuntary and painful erec-
 tions, and the heat and pain about the feat,  become eafier ; the run-
 ning alfo gradually decreafes, grows whiter and thicker, till at laft
 it entirely disappears.
   By attending to theSe Symptoms, the gonorrhoea may be general-
 ly diftinguifhed from any other difeafe.  There are however fome
 few diforders for which it may b? mistaken, as an ulcer  in the kid-
 nies or bladder, the fluor albus, or whites in women, &c.   But in
 the former of thefe, the matter comes away only with the urine, or
 when theTphinaer of the bladder is open  ; whereas, in a gonofr-
 hwea, the difeharge is conftant. The latter muft  be known chiefly
 from its effeas, as pain, communicating the infeaion, Szq.
   REGIMEN.----When a perfon fufpeas that  he has caught the
 venereal infeaion, he ought moft ftrictly  to obferve a cooling re-
 gimen,  to avoid every thing  of a heating nature,  as wines, Spiritu-
 ous liquors,  rich Sauces, Spiced, Salted, high-SeaSoned and Smoke-
 dried provisions,  aromatic and Stimulating vegetables,  as onions,
 garlic, Shallot, nutmeg, muftard, cinnamon, mace, ginger, and Such
 like.  His Sood ought  chiefly to confift cS  mild vegetables,  milk,
 broths,  light  puddings, panado, gruels, &c. His drink maybe bar-
 Jey-water, milk and water, decoaions of marfh-mallows  and liquo-
 rice, linfeed tea, or clear whey. Of thefe, he ought to drink plenty
 Suliy. Violent exerciSe of all kinds, efpecially riding on  horfeback,
 and venereal pleafures,  are to be avoided. The patient muft beware
 oS cold,  and  when  the  inflammation is violent, he ought to keep
 his bed.
   MEDICINE.-----A virulent gonorrhoea cannot always be cur-
 ed Speedily and efre&ually at the Same time. The padent ought not
 to expea, nor the phyfician  to promife it.   It will often continue
 for two  or three weeks, and fometimes for  five or Si::, even where
 the treatment ha3 been very  proper.
  Sometimes a flight infeaion may be carried off in a few days, by
feathino-  the parts in warm milk aud water,  and  in jetting frequent- 
   340         VIRULENT  GONORRHOEA.

   ly up the urethra a little fweet oil or linfeed-tea about the warmth
   of new milk. Should theSe not Succeed in carrying off the inSeaion,
   they will at leaft have a tendency to leffen its virulence.
     To effea a cure, iiowever, aftringent injeaions will generally be
   found neceffary. Thefe may be various  ways prepared, but I think
   thofe made widi the white vitriol are both moft SaSe and efficacious.
   They can be made Stronger or weaker as circumftances may require;
   but  it is beft to begin with the more gentle,  and increaSe their
   power if neceffary.   I generally order a drachm  of white vitriol to
   be diffolved in eight or nine ounces of common or rofe-water,  and
   an ordinary fyringe full of it to be thrown  up three or four times
   a-day. If this quantity does not perform a cure, it may be  repeated,
   and  the dofe increafed*.
     Whether injeaions be ufed or  not, cooling purges are always.
   proper in the gonorrhoea.  They ought not however to be of the
   ftrong or draftic kind.  Whatever raifes a violent commotion in the
   body increafes the danger, and tends to  drive the difeaSe deeper in-
   to the habit.   Procuring  two or three ftools every Second or third
   day  Sor the firft  Sortnight, and the fame number every fourth or
   fifth day for the fecond, will  generally be fufficient to remove the
   inflammatory fymptoms, to diminifh the running, and to change the
   colour and confiftence of the matter, which gradually becomes more
   white and ropy as the virulence abates-)-.

     *  Although it is now very common to cure the gonorrhoea  by pftrin-
   gent injections, there are ftill many  practitioners who do not approve
   this mode of practice. lean, from much experience,  alTert, that  it's
   both the moft eafy and efficacious method of cure ; any bad confequences
v  arifing from it muft be owing to the ignorance or mifconduct of the prac-
   titioner himfelf, and not to the remedy. Many, for example, life ftrong
   preparations of lead, all of which are dangerous when applied to the in-
   ternal furfaces of the body; others ufe efcharotics, which inflame and
   injure th?  parts.  I have known a gonorrhoea actually cured bv an-in-
   jectioa made of gree;i-tea, and would always recommend gentle  me-
   thods where they will fucceed.

      I  if the patient can fwallow a folution of falts  and manna, he  may
   take fix drachms,  or, if  his conftitution requires it, an ounce of the
   former, with half a-i ounce of the latter.  Thefe may be diffolved in an
   Englifh pint of boiling water, whey, or thin water-gruel,  and taken
   early in the morning.
     If an infufion of fenna and tamarinds be.more agreeable, two drachms
   of the former, and an ounce of the latter, maybe infufed ,t11 night in an
   Englifh pint of boiling water.  The infufion may be ftrained next morn-
   ing,  and half an ounce of Glauber's faits diffolved in it- A ic«-cupful of
   this  infuiion, may be taken every half hour till it operates.
     Should the patient prefer an electuary, the following will be found
   to anfwer very well.' Take of the lenitive electuary four ounces, cream
   of tartar two ounces, jalap in powder two drachms, rhubarb one drachm,
   and  as much of the fyrup of pale rofes as will ferve to make  up the
   whole into a foft electuary. Two or three tea-fpoonfuls of rhis may be
   taken over-night,  and  about the fame quantity next morning, every
   day  that the patient choofes to take a purge.
     The dofes of ihe above medicines may be increafed or diminifhed ac- 
             VIRULENT GONORRHOEA.          341

   When the inflammatory -fymptoms run high, bleeding is always
necefiary at the beginning.  This operation, as in other topical in-
flammations, muft be repeated according to the ftrength and confti-
tution of the patient, and the vehemence and urgency of the fymp-
toms.
   Medicines which  promote the fecretion  of urine, are proper in
this ftage of the diforder. For this purpofe, two ounces of pounded
arabic  may be mixed with half an ounce of cream tartar, and di-
vided into  twenty-four  dofes, one of which  may  be  taken every
morning and evening in a cup of the  patient's drink.   I have ge-
nerally'found this anfwer extremely well, both as to  the diuretic,
and for keeping the body gently open.
   When  the pain and inflammation are feated high towards the
neck of the bladder,  it  will  be proper frequently  to throw up  an
emollient  clyfter,  which, befides the benefit of procuring ftools,
will ferve  as a fomentation to the inflamed parts.
   Soft poultices, when they can conveniently be applied  to  the
parts, are  of great  fervice. They may be made  of the flour of lin-
fe'ed, or of wheat bread and milk, foftened with frefh butter or Sweet
oil.  When  poultices cannot be conveniently ufed, cloths wrung
out of warm water, or  bladders filled with warm milk and water,
may be applied. I  have often known the moft excruciating pains,
during the inflammatory ftate of the gonorrhoea, relieved by one
or other of thefe applications.
   Few  things tend more to  keep off inflammation in the fpermatic
veffels,  than a proper trufs Sor the Scrotum.  It ought to be fo  con-
trived as to fupport the tefticles, and fhould  be worn from the firft
appearance of the difeafe till it has ceafed fome weeks.
   The  above treatment will fometimes remove  the gonorrhoea  fe
quickly, that the perfon will be in doubt whether he really hbour-
ed under that difeaSe. This, however,' is too favourable a turn to
be often expeaed, and ought never  to be adopted.
   When  the above  treatment has removed the heat of urine, and
forenefs of the genital parts ; when the quantity of running is con-
fiderably leffened, without any pain or Swelling in the groin or tef-
ricle fupervening ;  when the patient is free  from involuntary erec-
tions;  and laftly, when the  running becomes pale, whitifli, thick,
void oS ill Smell, and  tenacious or ropy ;  when all or moft of theSe
Symptoms appear, the gonorrhoea is arrived at its laft ftage, -fmd we
may. gradually proceed to treat it as a gleet with aftringent medi-
CV.tSS.

cordinrr as the patient finds it neceffary. We hive ordered the falts to be
diilblved in a large quantity of v; ater, becaufe it renders ther operation
mere mild. 
C   342   ]
                          Of Gleets.

   A GONORRHCE A frequently repeated, or improperly treated,
oSten ends in a gleet, which may either proceed from relaxation, or
from fome remains of the difeafe. It is of the greateft importance
in the cure, to know from which caufe the gleet proceeds.  When
the diScharge proves very obftinate, and receives little or no check,
from aftringent medincines, there* is ground to SuSpea that it is owing
to the latter; but iS the drain is inconftant, and is chiefly ob/ervable
when the patient is Stimulated by laScivious ideas, or upon Strain-
ing to go to ftool, we  may reaSonably conclude  that it is chiefly
owing to the former.
   In  the cure of a gleet, proceeding from relaxation, the principal
defign is to brace, and reftore a proper degree of tenfion to the de-
bilitated and relaxed veflels.   For this purpoSe, befides the medi-
cines recommended in the gonorrhoea, the patient may have re-
courSe to Stronger and powerful aftringents, as the Peruvian bark*,
allum, vitriol, galls, tinaure of gum kino, &c. The injeaions may
be rendered more aftringent by the addition of a few grains of al-
lum, or increafing the quantity of vitriol as far as the parts are able
to bear it.
   The laft remedy which we fhall mention in this caSe is the cold
bath,'than which, there is not perhaps a more powerful bracer in the
whole compaSs of medicine. It ought never to be omitted in this fpe-
cies of gleet,  unlefs there be  fomething in the conftitution of the
patient which renders the ufe of it unfafe.  The chief objeaions to
the ufe of the ccld bath are, a full habit, and an unfound ftate of the
vifeera. The danger from theformer may always be leffened, if not re-
moved, by purging and bleeding; but the latter is an infurmountable
obftacle, as the preffure  of the water, and the fudden contraaion of
the external veflels, by throwing the blood with too much force up-
on the internal parts, are apt to occafion ruptures of the veflels, or
a flux of humours upon the difeaSed organs. But where no objeaion
oS this kind prevails, the patient ought to plunge over head in'wa-
ter every morning Salting,  Sor three or  four weeks together.   He
fliould not flay long in the water, and fhould have his fkin dried as
Soon as he comes out.
  The regimen proper  in this caSe  is the Same as  in the laft  SLtge
of the gonorrhoea : the diet muft be drying and aftringent, and the
drink, Spa,  Pyrmont, or Briftol  waters, v/ith which a  little claret
©r red wine may Sometimes be mixed. Any perSon may now afford

  -* The Peruvia-i bark may be combined with other aftringents, and
prepared in the fallowing manner :
 Take of Peruvian bark brnifed, fix drachms, of frefh galls bruifed, rwo
drachms ;  boil thfm '<n a pound and an half of water ro a pound : to the
it rained liquor add th/ee ounce.-- of the fi-nple tincture of the bark.   A
fmall te:i-cupful of* this may  be taken three  time; a-d-iy, adding to eacfc
• up fifteen or twejvry drop:,  of Che acid eil>.:r of vitriol. 
THE SWELLED TESTICLE..         343
to drink theSe waters, as they can be every where prepared at almoft
no expence, by a mixture of common chalk and oil of vitriol.
   When the gleet does not in the fmalleft degree  yield to thefe me-
dicines, there is reafon to SuSpea that it proceeds from ulcers*.  In
this cafe,  recourfe muft be had to mercury, and fuch medicines as
tend to correa any predominant acrimony with  which the juices
may be affeaed, a$ the decoaion  of China, fafaparilla, faffafras, or
the like.
   Mr. Fordyce fays, he has Seen many obftinate gleets of two, three,
or four years ftanding, effeaually cured by a mercurial inunaion,
when almoft every other medicine has been tried in vain. Dr. Chap-
man feems to be of the fame opinion ; but fays, he has always Sound
the mercury Succeed beft in this caSe when joined with terebinthi-
nate and other agglutinating medicines. For which reaSon, he re-
commends pills made oS calomel and Venice turpentinef ; and de-
 fires that their ufe  may be accompanied widi a decoaion of guaia-
 cum or farfaparilla.
   For  the cure of ulcers in the urinary paffage, Suppurating can-
 dles or bougies are prepared various ways, and are generally to be
 bought  ready  made.  It is needleSs to Spend time in enumerating
 the different ingredients of which they are compofed, or teaching
 the manner of preparing them. Before a bougie be  introduced in-
 to the urethra, it fhould be fmeared all over with fweet oil, to  pre-
 vent it from Itimulating too fuddenly ;  it  may be fuffered to conti-
 nue in from one to Seven or eight hours, according as the patient
 can bear it. Obftinate ulcers are not only often healed, but tumours
 and  excrefcences in the  urinary paffages taken away, and an ob-
 ftruaion of urine removed by means of bougies.
                  Of the  Swelled Teflicle.

  THE fwelled tefticle may proceed from infeaion lately contrac-
ted, and may happen both in the firft and fecond ftages of a gonorr-
hoea ; particularly wJien the running is unfeafonably checked, by

  • This conjecture mould be well-founded, as the fame effeft may be
produced from different caufes, fuch asa ftrifture in the urethra or hm-
Ke relaxation of the excreting veffels of that canal; in both of the!e
?ife"nTercnr^ would be improber, particularly in the former  which
can only be removed by a diligent ufe of bougies.         (1- C)

   t Take  Venice turpentine, boiled to a fufficient degree  of hardnefs
half Jn ounce caToLel, half a drachm. Let thefe be mixed and formed
!„SS, of whidi five -^S^^^^rtR,ath
l^^^^^^^^^^ *'« fyniptomsdifap-
pear. 
344.
BUBOES*
 cold, hard drinking, ftrong draftic purges, violent exercife, the too
 early uSe of aftringent medicines, or the like.
   In the inflammatory ftage, bleeding is neceffary, which muft be
 repeated according to the urgency oS the Symptoms*.   The food
 muft be light, and the  drink diluting. High-feafoned food, flefh,
 wines, and every thing of a heating  nature, are to be avoided.  Fo-
 mentations  are of Angular fervice.  Poultices of bread  and milk,
 foftened with frefh butter or oil, are very  proper, and ought con-
 ftantly  to be applied  when the patient is in bed; when he is up,
 the tefticle fhould  be  kept warm,  and Supported by a bag or trufs,
 which may eafily be contrived in  Such a manner as to prevent the
 weight oS the tefticle  Srom having any effea.
   If it fhould be found  impraaicable to  clear the tefticle by the
 cooling regimen now pointed out, aad extended according to cir-
 cumftances, it will be neceffary to lead the patient through fuch a
 complete antivenereal courfe, as fhall enfure him againft  any future
 uneafineSs. For this purpoSe, befides rubbing the mercurial ointment
 on the part, if free from pain, or on the thighs, as direaed in the
 gonorrhoea, the  patient muft be confined to bed, if neceffary, for
 five or fix  weeks,  fufpending the tefticle all the while with a bag
 or trufs, and plying him inwardly with ftrong decoaions of farfa-
 parilla.
   When thefe means do not fucceed, and there  is reafon to fuf-
 pea a fcrophulous or cancerous habit, either of which  may fup-
 port a'fehirrhous induration,  after the venereal poifon is combed,
 the parts fhould be fomented daily  with a decoaion of hemlock,
the bruifed leaves of which may likewife be added to  the poultice,
 and the extraa at the fame time taken inwardlyf.  This praaice is
 ftrongly recommended by Doaor  Stork in fehirrous and cancerous
cafes ; and Mr. Fordyce affures us, that by this  method he has  cu-
red diSeaSed tefticles oS two or three years ftanding, even when ulce-
rated, and when the Schirrous  had begun to be affeaed with prick-
ing and lancing pains.
                           Buboes

  ARE hard tumours Seated in  the groin, occafioned by the vene-
real poiSon lodged in this part.  They are of two kinds; viz. fuch
as proceed from a recent infeaion, and fuch as accompany a con-
firmed lues.

  *  F have been accuflomed for fome tim»paft to apply leeches to in-
flamed tefticles, which practice has always been followed with the moft
happy effects.
  t  The extract of hemlock may  be made into pills, and taken in the
 manner directed under the article Cancer. 
CHANCRES.                   *4$
  The cure of recent buboes, that is, fuch as appear foon after im-
pure coition, may be firft attempted by difperfion, and, if that fhould
not fucceed, by fuppuration. To promote the difperfion of a bubo,
the fame regimen muft be obferved as was direaed in the firft ftage
©f a gonorrhoea. The patient muft likewife be bled, and take fome
cooling purges, as the decoaion of tamarinds and fenna, Glauber's
Salts, and the like*.   IS, by  this courSe, the. Swelling and other inV
flammatory Symptoms  abate, we may Safely proceed to the ufe of
mercury, which muft be continued till the venereal virus is quite
fubdued-f,
:   But, if the bubo Should,  from the beginning, be attended with
great heat, pain, and pulfation, it will be proper to promote its fup-
puration.   For this purpofe, the patient may be allowed to ufe his
ordinary diet, and to take now and then a glafs, of wine. Emollient
cataplafms, confifting of bread and milk, or flax-feed flour, foften-
cd with oil or frefh butter, may be applied to the part; and, where
the tumour advances flowly, white lily-roots boiled, or fliced onions
raw, and a fufficient quantity of yellow bafilicon, may be added to
the poultice.
   When  the tumour is ripe,  which may be known by its conical
 figure, the foftnefs of the fkin, and a fluauation of matter plainly
to be felt under the finger, it may be opened by either cauftic or a
lancet^:, and afterwards dreffed with digeftive ointment.
   Sometimes buboes can neither be difperfed nor brought to a fup-
puration, but remain hard, indolent  tumours. In this cafe, the in-
 durated glands muft be confumed by cauftic.  If they fhould be-
 come  fehirrous, they muft be diffolved by the application of hem-
 lock, both externally and internally, as direaed in the fehirrous tef-
 ticle.
                          Chancres

  ARE fuperficial, callous, eating ulcers ; which may happen ei-
ther with or without a  gonorrhoea.  They are  commonly feated
about the glands, and make their appearance in the following man-
ner : Firft a little red pimple arifes, which foon becomes pointed

  * During the continnance of this practice, one drachm of the mercu*
rial ointment fhould be rubbed every night, into the infide of the thigh,
belowtae bubo.     '  (I. C)
  t For the difperfion of the bubo, a number of leeches applied to the
part affected, will be found equally efficacious as in the inflamed tef-
ticle.
  i The latter is more advantageous than the former ; if the bubo be
Simply punctured, and the matter difcharged gradually, foasto imitate
its fpontanious rupture.   This mode fliould always be prefered, when
the patient cannot wait for it to break of itfelf. 
346                   CHANCRES;

at top, and is filled-with a whitifh matter inclining to yellow* This
pimple  is hot, and itches generally before it breaks ; aSterwards ifc
degenerates into an obftinate ulcer, the bottom of which is ufually
Goveted  with a vifeid mucus, and whofe  edges gradually become
hard and callous. Sometimes the firft appearance refembles a fimple
excoriation  of the cuticle ; which, if the caufe be venereal, foon
becomes a true chancre.
   A chancre is fometimes a primary affeaioo, but it is muchoft-
ner Symptomatic,  and is the mark of a confirmed  lues.  Primary
chancres diScover themfelves foon after impure coition, and are ge-
nerally  Seated m parts covered with a thin cuticle, as the lips, the
nipples of women; the glans penis of men, &c*v
   When a chancre appears foon after impure coition, its treatment
is nearly fimilar to that of the virulent  gonorrhoea.  The patient
muft obferve the cooling regimen, lofe a little blood, andtake fioms
gentle dofes of Salts and manna. The parts affeaed ought frequent-
ly to be bathed, or radier foaked, in warm mil!; and water, and  if
the inflammation be great, an emollient poultice or cataplafm may
be applied to them.  This courfe will, in moft cafes, be fufficient  to
abate the inflammation, and prepare the patient for the ufe of mer-
cury*
   Symptomatic chancres are commonly accompanied with ulcer3
in the throat, noaurnal pains, fcurfy eruptions about the roots  of
the hair, and other  fymptoms of a confirmed lues.  Though they
may be feated in any of the parts mentioned above, they commonly
appear upon the private parts, or the infide of the thigh. They are
alfo lefs painful, but frequently much larger and harder than pri-
mary chancres.  As their cure muft depend upon that of the pox,  of
which they are only a fymptom, we fhall take no further notice  of
them till we come to treat of a confirmed lues j-.
   Thus we have related moft of the Jymptoms which accompany
or fucceed a virulent gonorrhoea, and have alfo given a fhort view
of their proper treatment; feveral others fometimes attend this dif-
eafe,  as a frangury or obftruaion of urine, a phymofs, parapbymo-
fts, Sec.
   A  Strangury may be occafioned either by a SpaSmodic constric-
tion,  or  an inflammation of the urethra and parts about the neck of

  * When venereal ulcers are feated  in the lips, the infection may  he
communicated by k fling.  I have feen very obftinate venereal ulcers in
the lips,  which I had all the reafon in  the world to believe were com-
municated in this manner.
  f>urfes ought ro beware of Suckling infected children, or having their
breafts drawn by perfons tainted with the venereal difeafe.  This cau-
tion is peculiarly neceffary for nurfes who refide in  the neighbourhood
of great towns.
  11 have found it anfwer extremely  well to fprinkle chancres twice
a-day with calomel. This will often perform a cure without anyothe
application whatever.  If the chancres are upon the glans. they may be
wartied with milk and water, alittle warm, and afterwards the calomel
may be applied as above.         ' ' 
CHANCRES.                   347
tTie bladder. In the former cafe, the patient begins to void his urine
mth tolerable eafe; but, as foon as it touches the galled or inflam-
ed urethra, a fudden conftriaion takes place, and the urine is void-
ed by Spurts, and fometimes hydrops only.  When the Strangury is
owing to an inflammation about the neck of the bladder, there is a
conftant heat and uneafinefs of the part, a perpetual defire to make
■water, while the patient can only render a few drops, and a trouble-
fome tenefmus, or conftant inclination to go to ftool.     •      ..
   When the Strangury is owing to SpaSm, Such medicines as tend
to dilute and blunt the/alt* of the  urine will be proper. For this
purpofe, befides the common diluting liquors, SoSt and cooling
r,mulfions, fweetened  with the Syrup of  poppies, may be ufed.
Should theSe not have the defired  effea, bleeding, and emollient
fomentations, will be neceffary..
   When the  complaint is  evidently owing to an  inflammation
about the neck of the bladder, bleeding muft be more liberally per-
formed, and  repeated  according to the urgency of the  fymptoms.
After bleeding, if the Strangury ftill continues, Soft clyfters, with a
proper  quantity of laudanum  in them, may be adminiftered, and
emollient fomentations applied to the region of the bladder.  At the
fame time, the patient may take every four  hours  a tea-cupful of
barley-water, to an English pint of which fix ounces of the fyrup of
marfh-mallows, Sour ounces of the oil of fweet almonds, and half
an ounce of nitre, may be added. If thefe remedies Should not re-
lieve the complaint, and  a total fuppreffion  of urine fhould come
on, bleeding muft be repeated, and the patient fet in a warm bath up
to the  middle. It will be  proper in this cafe to discontinue  the dm-
retics,and to draw off die water with a catheter;  but as tne patient is
feldom able to bear its  being introduced, we rather recommend the
ufe of mild bougies. Thefe often lubricate the paffage,  and greatly
facilitate the difeharge  of urine. When they begin to Stimulate cr
eive any uneafinefs, they may be withdrawn.
   The phymfts is fuch a conftriaion of the prepuce over the glans,
as hinders it  from being drawn backwards; the paraphyrnofs, on
the contiary, is fuch a conftriaion of die prepuce behind the glans,
as hinders it from being brought forward.                -,u *w
   The treatment of thefe fymptoms is fo nearly tne fame with that
of the  virulent gonorrhoea, that we have no occafion to enlarge up-
on it.   In general, bleeding, purging, poultices, and emolliuit fo-
 mentations  are fufficient.                      *.♦!„. ;„fl9m
  Sometimes in fpite of all endeavours to the contrary,  the mflam-
 mation goes on, and fymptoms of a beginning mortificanon app  .
 When this is the cafe,  the prepuce muft be Scarified wita lancet
 and if neceffarv, divided, in order to prevent  a ftrangulation, and
 ef th   im'rtnld glans at liberty. We fhall not defenbe^his ope
ration  as it ought always to be done by a Surgeon.  M hen a mor
«££LJ**f t^n place it will be n^ceflar^be  des ^
forming the above operations, to foment the parts frequent.) 
348            A  CONFIRMED LUES.

cloths wrung out of a ftrong  decoaion of camomilt-flQWcrs and
bark, and to give the patient a  drachm of the bark in powder every
two or three hours.
   With regard to the priapifm, chordee, and other distortions of the
penis, their treatment is no way different from that of the gonorr
rhcea. When they prove very troublefome, die patient may take a
few drops of laudanum at night, efpecially after the operation of a
purgative through the day.
                     Of a Confirmed Lues.

   WE have hitherto treated cf thofe affeaions, in which the vene-
 real  poifon is fuppofed to be  confined chiefly to the particular part
 by which it was received, and fhall next take a view of the lues  in
 in its confirmed ftate ; that is, when the poifon is aaually received
 into  die blood, and circulating with it through every part of the
 body, mixes with the feveral fecretions, and Tenders the whole ha-
 bit tainted.
   The fymptoms of a confirmed lues are, buboes in the groin, pains
 of the head and  joints,  which are peculiarly troublefome in the
 night, or when the patient is  warm in bed ; fcabs and feurfs in va-
 rious parts of the body, efpecially  on the head, of a yellowifh co-
 lour, fefembling a honey-comb; corroding ulcers in various parts of
 the  body, which generally begin about the throat, from  whence
 they creep gradually, by the palate, towards the cartilage of the nofe,
 which they deftroy ; excrefcences or exoftofes arife in the middle
 of the bones, and their fpongy ends become brittle, and break upon
 the leaft accident; at other times they are foft, and bend like wax;
 the conglobate glands become hard and callous, and form, in the
 neck, armpits, groin, and mefentcry, hard  moveable tumours, like
 the king's evil; tumours of different kinds are likewiSe formed  in
 the lymphatic veffels, tendons, ligaments, and nerves, as the gum-
 mata, ganglia, nodes, tophs, &c.; the eyes are affeaed with itching,
.pain, redneSs, and Sometimes with total blindnefs, and the ears with
 a finging noife, pain and deafnefs, whilft their internal fubftance is
 exulcerated and rendered carious;  at length all the animal, vital,
 and natural funaions are depraved;  the face becomes pale and li-
 vid ;  the body emaciated and unfit for motion, and the patient Sails
 into an atrophy or wafting consumption.
   Women have  Symptoms peculiar to the fex; as cancers of the
breaft j  a fuppreffion or overflowing of the menfes ; the whites 5
hyfteric affeaions; an inflammation, abSceSs, fchirrus,  gangrene,
cancer, or ulcer of the womb ; they are generally either barren or
fubjea to abortion ; or, if they bring children into the world, they
have an unjverial eryfipelas, are half rotten, and covered with ul-
cers* 
A CONFIRMED LUES.             349
  Such is the catalogue of fymptoms attending this difeafe in its
confirmed ftate.  They are feldom all to be met with in the fame
perfon, or at the  fame time; fo many of them, however, are gene-
rally prefent as are Sufficient to alarm the patient; and if he has rea-
fon to fuSpea the infeaion is lurking in his body, he ought immej
diately to.fet about the expulfion of it, otherwife the moft tragical
confequences will enfue.
   The only certain remedy hitherto known in Europe, for the cure
of this difeafe, is mercury, which may  be ufed in a great variety of
forms, with nearly the fame fuccefs. Some time ago it was reckon-
ed impoflible to cure a confirmed lues without a •falivation.  Thi«
method is now generally  laid afide, and mercury is  found to be as
efficacious, or rather  niore fo, in expelling the venereal poifon,
when adminiftered in fuch a manner as not to run  off by the fah-
vary glands.
   Though many are of opinion, that the mercurial ointment is at
 efficacious as any other preparation of that mineral; yet experience
 lias taught me to think otherwife.  I have often feen the  moft ob-
 ftinate  venereal cafes, where  great  quantities of mercurial oint-
 ment had been ufed in vain, yield to the faline preparations of mer-
 cury. Nor am I Singular in this opinion.  My ingenious friend, Mr.
 Clare, an eminent furgeon of this city, affures me, that  for fome
 timepaft, he has employed, in venereal cafes, a faline preparation
 of mercury with moft happv  SucceSs. This preparation, rubbed
 jvirh a Sufficient quantity oS any  mild powder,  he applies, m Small
 portions, to the  tongue, where, with a gentle degree of friaion, it
 is immediately abforbed,  and produces its full  effea upon the fyf-
 tem, without doing the leaft injury to the ftomach or bowels; a
 matter of.the greateft importance in  the application of this  moft
 adive and powerful remedy*.                             .
   It is impoifible to afecrtain cipher the exaa quantity of medicines
 that muft be taken, or the time they ought to be continued, in or-
 der to  perform  a cure. Thefe  vary according to the conftitution of
 the patient, the feafon of the year, the degree of infeaion, the time
 it has lodged in the body, &c. It is difficult to determine a prion,
 what quantity of mercury will be neceffary to cure this diftemper
 completely; yet it may be judged of a  pjteriort,  from the abate.
 rnein and ceafing of the fymptoms.   Aftruc fays, that commonly

   * The beft method of introducing mercury into the fyftem to^reme-
 dy this difeafe, is by mercurla lou^neat »™^l^^% 
35°
A CONFIRMED LUES.
  not lefs than two ounces of the ftrong  mercurial ointment is fuffi-
  cient, and not more than three or four ounces necefTary.
    The only other preparation of mercury which we fhall take no-
  tice of, is the corrofive fublimate*. This was fome time ago brought
  into uSe for the venereal diSeaSe, in Germany, by Baron Van Swie-
  ten ;  and was foon after introduced into Britain by Sir John Prirv-
  gle.  The method of giving it is as follows : One grain of corrofive
  fublimate is diffolved iH two ounces of French brandy or malt fpi-
  rits ;  and of this Solution, an ordinary  table-fpoonful, or the quan-
  tity of half  an ounce, is to be ukcn twice a-day, and to  be  conti-
  nued as long as any fymptoms of  the  diforder remain.  To  thofe
  whofe ftomach cannot bear the folution, the fublimate may be gi-
  ven in form of pillf.
    Several roots, woods, and  barks, have been recommended for
  curing  the  venereal difeafe; but none have upon experience an-
  fwered the high encomiums beftowed upon them.  Though no one
  of thefe is to be depended upon alone,  yet, when joined with mer-
  cury, fome of them are  found to be very beneficial in promoting a
  cure. One of the beft is  SarSaparilla, which may be prepared and
  taken according to the direaions in the appendix J.
    The  mezereon-root is found to be a powerful^afliftant to the Sub-
  limate,  or any odier mercurial. It may be uSed along with the Sar-
  faparilla, as  direaed in the appendix, or by itfelf. Thofe who choofc
  the mezereon by itfelf, may boil an ounce of the frefh bark,  taken
  from the root, in twelve Englifh pints cf water to eight, adding to-
  wards the end an ounce of; liquorice. The dofe of this is  the fame
  as of the decoaion of farfaparilla.
    We have been told that the natives  cf America cure die vene-
  real  difeafe, in every ftage, by a decoaion of the root of a plant
  called the Lobelia.  It is ufed either frefh or  dried; but we have
  no certain accounts with regard to the-proportion.  Sometimes they
  mix other roots with it, as thofe of the ranunculus, the ceanothus,
  &c.; but whether thefe are defigned to difguife cr affift it, is doubt-
  ful. The patient takes a large draught  oi the decoaion early in the
  morning, and  continues to uSe it for his ordinary drink through
  theday§.

   * This preparation of mercury is rhoncrhr. to be more efficacious than
 zny other, in venereal affections of the h-in.      I. C.
   t The  fublimate may be ;)ven in diftilled witer. or any  other li-
 quor that the patient choofes. I commonly order tengrains to be diffolv-
 ed in an  ounce of the fpirit of wine,  for the conveuiency of carriage,
 and let the patient take rwenry or thirty drops of it night zni\ morning
 in half a glafs of brandy or other fpirits.  Mr,.  Debraw, l-i ingenious
 chemift of this place, prepares a fait of mercury much more mild and
 gentle in its operation than ihe fublimate,  though equally efficacious.
   J See Appendix, Decoct, cf' Sarfaparitla.
  \ Though we are ftill very much in the'dark with regard to the me-
 thod of curing this difeafe among the natives of America, yet it  is ge-
 nerally affirmed, that they do < i:re it with fpeed,  iafetyT. »nd fuccefs
and that without ihe leaft knowledge of mercury. Hence ir  becomes
an object  of conliderable imp'>rcame to difcover thfir inrrhod of fure. 
A CONFIRMED LUES.
35*
  Many oth.r roots and woods might be mentioned which have
been extolled for curing the venereal  difeafe, as the china-root,
the roots of foap-wort, burdock, &c. as alfo the wood of guaiacum
and faffafras ; but, as none of thefe pofleSs virtues Superior to thoSe
already mentioned, we fhall pafs them over, and -hail conclude our
obfervations on this difeafe, with a few general remarks concerning
the proper management of the patient* and the nature of the infec-
tion.
                     General Obfervations.

   THE condition cf the patient ought always to be confidered pre-
 vious to his entering upon  a courfe of mercury in any form.  It
 would be rafh and dangerous to adminifter mercury to a perfon la*-
 bouring uhder any violent acute difeafe,  as fevers, pleurify, perip-
 neumony, or the like. It would be dangerous in fome chronic ca-
 fes ; as  a flow heaic fever, or the laft  ftage  of  a confumption.
 Sometimes, however, thefe difeaSes proceed Srom a confirmed lues j
 in which caSe, it will be  neceffary to give mercury. In chronic dif-
 eaSes of a lefs dangerous nature, as the afthma, the gravel, and fuch
 like, mercury, if neceffary, may be fafely adminiftered. If the  pa-
 tient's ftrength has been greatly exhaufted by ficknefs, labour, ab-
 stinence, or any other caufe, the ufe oS mercury muft be poftponed,
 till, by time, reft, and  a nourifhing diet, it can be Sufficiently re-
 stored.
   Mercury ought  not to be adminiftered to women during the
 menftrual flux, or when the period is near at hand.  Neither fhould
 it be given in the laft  Stage of pregnancy.   If the woman be not
 near the time of her delivery, and circumftances render it  neceffa-
 ry, mercury may be given, but in fmaller dofes, and at greater in-
 tervals than ufual : with theSe precautions, both the  mother and
 child may be cured at the fame time; if not, the diforder will ire
leaft be kept from growing worfe, till the woman  be  brought  to
 bed, and fufficiently recovered, when a more effeaual  method may
 be purfued, which, if fhe fuckles her child, will in al4 probability be
 fufficient for the cure of both.
  Mercury fhould be adminiftered to infants with the greateft cau-

 This might furely be done by making trials of the various  plants which
 are found ia thofe parts, and particularly of fuch as the uatives are
known to make ufe of. All people in a rude ftate take their medicines
chiefly from the vegetable kingdom, and are often polfeffed of valuable
fecrets with regard to the virtues of the plants, of which more enlight-
ened nations axe ignorant.  Indeed,  we make no doubt but fome plants
of our o*n growth,  were proper pains taken to difcover  them, would
be found as efficacious in curing the, venereal difeafe a» thofe of Ameri-
ca.  It ninft however be remembered, that what wjll cure the.yenere»l
difeafe in one country, will not always have equal fuccefs in another. 
352            A CONFIRMED  LUES.

tion. Their tender condition unfits them Sor Supporting a Salivation,
and makes it neceffary to give even the mildeft preparations of mercu-
ry to them with a fparing hand.  A fimilar condua is recommended
in the treatment of old perfons, who labour under a confirmed lues*
The infirmities of age muft render people lefs able to undergo the
fatigues of a falivation; but this, as formerly obferved, is never ne-
ceffary ;  befides, we have generally found, that mercury had much
lefs effea upon very old perfons than on thofe who were youngtR
   Hyfteric and hypochondriac perSons, and Such as are Subjea to
an habitual diarrhoea* or dyfentery j or to frequent and violent at-
tacks of the epilepfy, or who are  affliaed with the ferophula, or
the feurvy, Ought to be cautious in the ufe of mercury. Where any
one of diefe diforders  prevails, it ought, if poffible, to be cuf ed, or
at leaft palliated, before the patient enters upon a courfe of mercu-
ry. When this cannot be done, the mercury muft, be adminiftered
in fmaller dofes, and at longer intervals than ufual.
   The moft proper feafons fey  entering upon a courfe of mercury
are, the  fpring and autumn, when the air is of a moderate warmth.
If die circumftances of the cafe will not admit of delay, we muft
not defer the cure on account of the feafon, but muft adminifter the
mercury;  taking care at the fame time to keep the patient's cham-
ber warmer or cooler, according as the feafon of the year requires.
   The next thing to be confidered is the preparation to be ohferved
before we proceed to a courfe of mercury.  Some lay great ftrefs
upon this circumftance, obferving, that by previoufly relaxing the
veffels, and correaing  any diforder which may happen to prevail
in the blood, not only the mercury will be  difpofed to act: more
kindly, but many other inconveniencies will be prevented.   '
   We have already recommended bleeding and gentle purges, pre-
 vious  to the administration of  mercury, and fhall only now add,
that thefe are always  to be repeated according to the age, ftrength,
 conftitution, and other circumftances of the patient.  Afterwards, if
it can be conveniently done,  the patient ought to bathe once or
 twice a-day, for a few days, in lukewarm water.  His diet in the
mean time muft be light, moift, and cooling.  Wine, and all heating
liquors,  alio violent bodily exercife, and all great exertions of die
mind, are carefully to be avoided.
   A proper regimen is to be obferved by feich as are under a coUrfe
of mercury. Inattention to thi